Association Between Sleep Disorders and Adverse Cardiovascular Outcomes in Patients with Chronic Obstructive Pulmonary Disease: Insights from the UK Biobank.

BACKGROUND AND OBJECTIVE: A potential association between sleep disturbances and adverse cardiovascular prognoses has been proposed in patients with chronic obstructive pulmonary disease (COPD), although high-quality confirmatory evidence remains limited. Sleep disturbances may contribute to increased cardiovascular risk through multiple biological pathways, including chronic intermittent hypoxia, systemic inflammation, and metabolic dysregulation. This study aimed to examine the association between sleep disturbances and adverse cardiovascular events in patients with COPD.

MATERIALS AND METHODS: A prospective cohort study of 21423 UK Biobank participants with COPD. We set the research subjects as non-sleep disorder group and sleep disorder group. Outcomes included stroke, heart failure (HF), atrial fibrillation (AF), angina pectoris, and myocardial infarction (MI). Cox proportional hazards models were applied with adjustment for sociodemographic and lifestyle factors to evaluate the association between sleep disorders and subsequent cardiovascular outcomes.

RESULTS: In this manuscript, compared with COPD patients in the non-sleep disorder group, sleep disorder group had a 79% higher risk of HF (HR = 1.79, 95% CI: 1.57-2.03). Moreover, sleep disorder had a 49% higher HR for AF (HR = 1.49, 95% CI: 1.32-1.68) and a 44% higher HR for angina development (HR = 1.44, 95% CI: 1.23-1.68). The risk of MI was also increased by 0.24-fold in the sleep disorder group (HR = 1.24, 95% CI: 1.01-1.54). Furthermore, male sex, older age, previous cardiovascular medication use, smoking, and obesity were significantly associated with elevated cardiovascular risk among COPD patients with sleep disorders.

CONCLUSION: Sleep disorders are associated with an increased risk of adverse cardiovascular outcomes in COPD patients. These findings suggest that identification and appropriate management of sleep disorders could potentially contribute to improved cardiovascular risk profiles in this population.