The bidirectional nature of the association between comorbidity and obstructive sleep apnoea

Abstract

Comorbidities of obstructive sleep apnea (OSA) includes metabolic, cardiovascular, renal, pulmonary, and mental disorders. Significant evidence indicates which OSA is an additional risk factor associated with numerous of these co-morbidities; however, there is also mounting evidence that several of these co-morbidities may lead to an occurrence of OSA. There is also mounting evidence of a two-way causality between OSA and comorbidities, particularly in the cases of heart failure, metabolic syndrome, and stroke. While retention of fluid and redistribution may play a larger role in comorbidities like heart failure and advanced renal disease, neurological processes may play a larger role in comorbidities like diabetic nephropathy and stroke. There is weak evidence to establish a two-way causal link between OSA and other comorbidities; instead, the data suggests that OSA primarily causes these conditions. This review focuses on co-morbidities that have been linked to an increased risk of OSA and examines the research supporting for such reciprocal interactions. Treatment's reciprocal effects are discussed to further emphasize the significance of precise diagnosis in clinical practice. This is particularly true of chronic obstructive pulmonary disease (COPD), where the detection of concurrent OSA has significant consequences for optimal treatment.