Obstructive Sleep Apnea Syndrome: Complications

The following are the major diseases or complications that may be contributed to by obstructive sleep apnea syndrome (OSAS):

Respiratory system (J00-J99)

  • Pneumonia (inflammation of the lungs; due to nocturnal aspiration/intrusion of liquid or solid substances into the respiratory tract).

Eyes and eye appendages (H00-H59).

  • Glaucoma (especially normal-tension glaucoma).
  • Thrombosis of the retinal veins (vena centralis retinae; RVO = retinal vein occulsion).

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Obesity (overweight)
  • Diabetes mellitus type 2
  • Hyperuricemia – see below arthritis urica/gout-related joint inflammation.
  • Metabolic syndrome

Cardiovascular system (I00-I99)

  • Arterial hypertension (high blood pressure).
  • Atherosclerosis (arteriosclerosis, hardening of the arteries)
  • Apoplexy (stroke)
  • Triggering a myocardial infarction (heart attack) in the presence of coronary artery disease (CAD).
  • Cor pulmonale (dilatation (widening) and/or hypertrophy (enlargement) of the right ventricle (main chamber) of the heart as a result of pulmonary hypertension (increased pressure in the pulmonary circulation)
  • Cardiac arrhythmias (including atrial fibrillation (AF) and sinus arrhythmias/AV blocks); OSA is also a risk factor for AF at age > 75 years, although it is weaker than central sleep apnea
  • Coronary artery disease (CAD).
  • Sudden cardiac death (PHT)
  • Pulmonary hypertension (pulmonary hypertension)
  • Deterioration of the left ventricular pumping function of the heart (left heart failure) in existing heart failure (heart failure).

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

  • Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the abnormal reflux (reflux) of acid gastric juice and other gastric contents; Incidence (frequency of new cases) circa 20-65%; the apnea-related hypoxemia (lack of oxygen in the blood) and hypercapnia (increase in arterial partial pressure of CO2) leads to a decrease in pressure in the lower esophageal sphincter (sphincter of the esophagus) and the night waking and lying position at the same time increase the abdominal pressure (pressure in the abdominal cavity)

Musculoskeletal system and connective tissue (M00-M99).

  • Arthritis urica/gout-related joint inflammation (gout)-5.8 years after OSA diagnosis, 4.9 percent of subjects developed gout compared with 2.6 percent in the non-OSA group; the association was most pronounced in subjects with normal body mass index (hazard ratio: 2.02 (1.13-3.62) 1-2 years after diagnosis)

Neoplasms – Tumor Diseases (C00-D48).

Psyche – nervous system (F00-F99; G00-G99).

Pregnancy, childbirth and puerperium (O00-O99)

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Cephalgia (headache; morning holocephalic headache).
  • Secondary polyglobulia (isolated elevated erythrocyte count (red blood cell count) with normal plasma volume)
  • Daytime sleepiness/increased daytime sleepiness.

Further

  • High risk of accidents and injuries due to microsleep – about 7 times higher accident rate than other motorized road users.
  • Risk factor in perioperative medicine: decreased inspiratory activation of airway dilator muscles (eg.B. by anesthetics, sedatives, and muscle relaxants; failed mask ventilation and/or intubation)Risk factor in the postoperative period: study patients who had suffered a cardiovascular complication experienced a drop in blood oxygen levels (< 80%) during the first three postoperative nights for an average duration of 23 minutes.Recommendation: preoperative OSA screening.