Obstructive sleep apnea (OSA) is increasingly recognized as an independent cardiovascular risk factor. Yet most health systems have been slow to act on this. This article traces the growing, and still underutilized, role of sleep in cardiovascular care: The biological pathways linking OSA to heart disease, the evolving frameworks for understanding it, and the gap between scientific evidence and clinical implementation.
This article examines how obstructive sleep apnea (OSA) is incorporated into cardiovascular disease prevention, screening, and treatment frameworks, reviewing how — and whether — that recognition translates into clinical pathways.
Obstructive sleep apnea (OSA) is increasingly recognized as a cardiovascular risk factor — but how far has that recognition traveled into the prevention frameworks that shape clinical care? This article examines cardiovascular prevention guidelines across six health systems and finds that sleep remains largely absent or peripheral. The gap between clinical evidence and prevention policy remains substantial.
Patients with obstructive sleep apnea (OSA) fall out of care at four predictable stages: Delayed or missed diagnosis, barriers to treatment initiation, therapy drop-off due to adherence challenges, and the absence of pathways back into care once treatment stops. This is not primarily a clinical failure, it is a structural one.
Despite strong biological evidence linking obstructive sleep apnea (OSA) to cardiovascular disease, integration into cardiovascular care pathways remains inconsistent across health systems. This article synthesizes findings from a Sleep Institute comparative analysis of six major health systems, identifies three distinct models of integration — siloed, partial and condition-specific, and systematic — and considers what more integrated care could involve. A key finding: The case for integration extends beyond the direct cardiovascular effects of positive airway pressure (PAP) therapy to risk stratification, blood pressure management, and care coordination.
This piece focuses on COMISA, the co-occurrence of insomnia and obstructive sleep apnea. In midlife women, OSA is often the missed or undertreated component, while insomnia and sedative use dominate the clinical conversation.
At World Sleep 2025, international experts shared firsthand insights on what's broken and what's working in global OSA diagnosis. Hear the discussion on tackling missed diagnosis, challenging outdated norms and building new models of care.
