Obstructive sleep apnea and its relationship with cardiovascular diseases

Abstract

Objective: To describe the relationship between obstructive sleep apnea (OSA) and the development of cardiovascular diseases (CVD), emphasizing pathophysiological mechanisms and therapeutic strategies. Methods: An integrative review was conducted using the PubMed/MEDLINE, LILACS, SciELO, Embase, and Scopus databases, applying the descriptors “Obstructive Sleep Apnea,” “Cardiovascular Diseases,” “Pathophysiology,” and “Treatment,” combined with the Boolean operator “AND.” Original articles published between 2017 and 2025, in Portuguese, English, or Spanish, with full-text availability, were included. Study selection was performed using the Rayyan software. Results: Thirteen studies were included. OSA was associated with intermittent hypoxia, oxidative stress, systemic inflammation, endothelial dysfunction, and sympathetic activation, contributing to arterial hypertension, atrial fibrillation, and heart failure. Characteristics such as obesity, age, and cardiovascular comorbidities modulated pathophysiological expression and therapeutic response. Continuous positive airway pressure (CPAP) showed benefits mainly in intermediate outcomes, though effectiveness was limited by low adherence. Alternative strategies, including mandibular advancement devices, upper airway surgery, and dapagliflozin, showed promising results but lack confirmation in major cardiovascular outcomes. Final considerations: OSA is a relevant risk factor for CVD, and therapeutic individualization may reduce cardiovascular complications.