The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis

Neurol Sci. 2022 Jan;43(1):219-231. doi: 10.1007/s10072-021-05765-3. Epub 2021 Nov 19.


Background: Obstructive sleep apnea (OSA) is a disorder characterized by intermittent airway obstruction during sleep. The association between OSA and the incidence of cardiovascular disease (CVD) has been investigated in many studies; however, the results are not entirely consistent between studies. The aim of this study was to investigate the relationship between OSA and the risk of CVD through a meta-analysis of cohort studies.

Methods: A systematic review and meta-analysis of literature was conducted using the PubMed, WoS, Embase, ScienceDirect, Scopus, and Web of Science databases up to the year 2020. In order to analyze the eligible studies, the stochastic effects model was used and the heterogeneity of the studies with the I2 index was investigated. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2).

Results: A total of 24 studies were included in the meta-analysis according to the inclusion criteria. Twelve studies reported CVD results, 11 studies reported stroke results, 9 studies reported mortality results, and 8 studies reported CVD results. The odds ratio of CVD in patients with OSA 1.71 (1.17-2.27: 95% confidence interval) stroke in patients with OSA, 1.86 (1.28-2.69: 95% confidence interval), mortality in patients with OSA, 1.77 (1.37-2.29: 95% confidence interval) and CHD in patients with OSA, and 1.48 (1.06-2.28: 95% confidence interval) was obtained.

Conclusion: OSA is considered a cardiovascular risk factor. There is a relationship between the severity of OSA and the risk of cardiovascular disease. OSA increases the risk of heart attack, CHD, and death from cardiovascular disease.

Keywords: Cardiovascular; Death; Ischemic heart disease; Mortality; Obstructive sleep apnea; Stroke.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Cardiovascular Diseases* / epidemiology
  • Cohort Studies
  • Humans
  • Incidence
  • Odds Ratio
  • Risk Factors
  • Sleep Apnea, Obstructive* / complications
  • Sleep Apnea, Obstructive* / epidemiology