Table 1 Summary of epidemiological evidence for potential associations between obstructive sleep apnoea (OSA) and cardiovascular and metabolic diseases
Medical conditionStudy designData support significant associationComments
HypertensionCross sectional (prevalence)YesCross sectional studies have shown that OSA is associated with hypertension independent of obesity Adults with OSA are almost 3 times more likely to develop hypertension compared to those with no OSA
Prospective cohort (incidence)Yes
Coronary heart diseaseCross sectional (prevalence)YesAdults with severe OSA (AHI >30 events per h) have more fatal and nonfatal cardiovascular events No prospective data assessing OSA and risk of developing coronary heart disease in adult populations
Prospective cohort (incidence)NA
StrokeCross sectional (prevalence)YesOSA is common in patients that have had a stroke Moderate-to-severe OSA is an independent risk factor for stroke Severe OSA is a risk for development of ischaemic stroke
Prospective cohort (incidence)Yes
Metabolic disordersCross sectional (prevalence)YesOSA is associated with insulin resistance, glucose intolerance and type 2 diabetes Prospective studies assessing the risk of developing diabetes show conflicting results or show weak associations at best
Prospective cohort (incidence)Yes
Heart failureCross sectional (prevalence)YesAdults with OSA are 2 times more likely to have heart failure after adjusting for important confounders No prospective data assessing OSA and risk of developing left ventricular hypertrophy or heart failure
Prospective cohort (incidence)NA
Atrial fibrillationCross sectional (prevalence)YesAtrial fibrillation common in OSA patients OSA is independently associated with atrial fibrillation, though no data are available to support the risk of incident events
Prospective cohort (incidence)NA
  • NA: not available; AHI: apnoea–hypopnoea index.