Extract
Obstructive sleep apnoea (OSA), characterised by recurrent upper airway obstruction, intermittent hypoxia and fragmented sleep, affects >15% of the adult population, with prevalence increasing markedly with advancing age and age-related cardiometabolic and pulmonary disorders [1]. Causal associations between OSA and hypertension, coronary heart disease, diabetes, heart failure, atrial fibrillation, stroke and mortality are suggested by numerous large prospective studies [2], raising the possibility that effective treatment of OSA might provide a novel strategy for primary and secondary prevention of cardiometabolic disease. However, randomised controlled trials have not yet produced evidence that use of a device for splinting the airway (i.e. continuous positive pressure) improves clinical cardiovascular disease. Multiple potential reasons for these disappointing results have been suggested, ranging from inadequate use of continuous positive pressure due to device intolerance, to exclusion of individuals from the trials who are most susceptible to OSA-related adverse outcomes. It is increasingly evident that there is a need to better identify OSA phenotypes that predict individuals at highest risk for developing chronic disease, as well as the underlying OSA disease mechanisms most amenable to targeted interventions.
Abstract
Comments on a FinnGen sleep apnoea genetics study: need to disambiguate causal and pleiotropic associations with obesity/cardiometabolic diseases and opportunities for biobanks (and deeper phenotyping) to discover new treatments and disease subtypes https://bit.ly/3dntk0I
Footnotes
Conflict of interest: H. Wang has nothing to disclose.
Conflict of interest: M.O. Goodman has nothing to disclose.
Conflict of interest: T. Sofer has nothing to disclose.
Conflict of interest: S. Redline reports grants from NIH, during the conduct of the study; and grants and personal fees from Jazz Pharma. In addition, S. Redline is the first incumbent of an endowed professorship donated to the Harvard Medical School by Dr. Peter Farrell, the founder and Board Chairman of ResMed, through a charitable remainder trust instrument, with annual support equivalent to the endowment payout provided to the Harvard Medical School during Dr. Farrell's lifetime by the ResMed Company through an irrevocable gift agreement.
Support statement: Supported by National Heart, Lung, and Blood Institute (grant: R35 135818) Funding information for this article has been deposited with the Crossref Funder Registry.
- Received December 28, 2020.
- Accepted February 10, 2021.
- Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org