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Cardiolucent

Condition

Obstructive Sleep Apnea

Cardiovascular screening and treatment coordination for one of the most underdiagnosed risk factors.

Obstructive sleep apnea (OSA) is a sleep disorder in which the upper airway repeatedly collapses during sleep, producing pauses in breathing, drops in oxygen, and surges in blood pressure and sympathetic activity. From a cardiology perspective, untreated OSA is a major modifiable risk factor for hypertension, atrial fibrillation, heart failure (both HFrEF and HFpEF), stroke, and pulmonary hypertension. It is also one of the most underdiagnosed conditions in cardiology, with millions of affected patients going untreated for years. Screening and treating OSA can meaningfully improve blood pressure control, reduce atrial fibrillation burden, and improve heart failure outcomes. Dr. Kedan asks about sleep at every visit and coordinates with sleep medicine for diagnosis and treatment.

What Cardiolucent Evaluates

  • Sleep history including snoring, witnessed apneas, daytime sleepiness, and unrefreshing sleep
  • STOP-BANG or similar screening questionnaire
  • Blood pressure pattern, particularly nocturnal and resistant hypertension
  • Screening for atrial fibrillation and other arrhythmias
  • Echocardiography to assess for right heart strain and other structural effects
  • Coordination with sleep medicine for home sleep apnea testing or in-lab polysomnography
  • CPAP adherence support and integration with cardiovascular care

Common Symptoms

  • Loud snoring, often reported by a bed partner
  • Witnessed pauses in breathing during sleep
  • Daytime sleepiness and fatigue
  • Morning headaches
  • Unrefreshing sleep despite adequate time in bed
  • Difficulty concentrating, mood changes, and decreased libido
  • Frequent nighttime urination
  • Many patients are unaware of their nighttime symptoms

Risk Factors

  • Obesity, particularly central obesity
  • Male sex (though risk in women rises after menopause)
  • Older age
  • Large neck circumference
  • Anatomic factors: large tonsils, narrow airway, recessed jaw
  • Family history of sleep apnea
  • Alcohol or sedative use, especially close to bedtime
  • Smoking
  • Nasal congestion or septal deviation

How Cardiolucent Approaches Treatment

Effective treatment of OSA begins with diagnosis through home sleep apnea testing or in-lab polysomnography, coordinated with sleep medicine. Continuous positive airway pressure (CPAP) remains the most effective treatment for moderate to severe OSA, with newer options including oral appliances, positional therapy, and hypoglossal nerve stimulation for selected patients. Weight loss has substantial impact, particularly with newer GLP-1 medications. Dr. Kedan integrates OSA treatment with cardiovascular care: monitoring blood pressure response, reassessing atrial fibrillation burden, and titrating cardiovascular medications as the apnea improves.

Common Questions

Frequently Asked Questions

What is obstructive sleep apnea?
OSA is a condition in which the upper airway repeatedly collapses during sleep, producing pauses in breathing, drops in oxygen, and physiologic stress that drives cardiovascular consequences. It is distinct from central sleep apnea, in which the brain's signaling to breathe is impaired.
Why is OSA a cardiology concern?
Untreated OSA contributes substantially to hypertension (especially resistant and nocturnal hypertension), atrial fibrillation, heart failure (both HFrEF and HFpEF), stroke, and pulmonary hypertension. Treating OSA can meaningfully improve all of these.
How is OSA diagnosed?
Diagnosis is made through sleep testing — either home sleep apnea testing for patients with high pretest probability and no significant comorbidities, or in-lab polysomnography for more complex cases. Dr. Kedan coordinates appropriate testing with sleep medicine.
What is the apnea-hypopnea index (AHI)?
The AHI is the number of breathing pauses (apneas) and partial obstructions (hypopneas) per hour of sleep. It classifies OSA severity: mild (5–14), moderate (15–29), and severe (≥30). Severity guides treatment intensity, though symptom burden and cardiovascular effects also matter.
Does CPAP really help cardiovascular outcomes?
CPAP reliably improves blood pressure, particularly nocturnal and resistant hypertension, and reduces atrial fibrillation recurrence after cardioversion or ablation. Cardiovascular event reduction has been harder to demonstrate, partly because adherence is challenging, but symptom and quality-of-life benefits are well established.
What if I cannot tolerate CPAP?
Several alternatives exist: oral appliances, positional therapy for patients whose apnea occurs mainly when sleeping on the back, and hypoglossal nerve stimulation for selected patients with moderate to severe OSA. Weight loss can dramatically reduce or eliminate apnea in many patients. Dr. Kedan coordinates with sleep medicine to find the right approach.
Can weight loss cure OSA?
Significant weight loss can substantially reduce or eliminate OSA in many patients, particularly with the substantial loss now achievable with GLP-1 medications or bariatric surgery. Sleep testing is often repeated after major weight loss to determine whether ongoing treatment is still needed.
I do not feel sleepy — could I still have OSA?
Yes. Many patients with significant OSA do not report classic daytime sleepiness, particularly women and patients who have adapted to chronic sleep disruption. Cardiovascular consequences occur even without subjective sleepiness, which is why screening based on cardiovascular features (resistant hypertension, atrial fibrillation, heart failure) is so important.
How does OSA fit with my atrial fibrillation or hypertension?
Untreated OSA is a major driver of atrial fibrillation recurrence and resistant hypertension. Treating OSA can meaningfully reduce AFib burden and lower blood pressure, sometimes allowing reduction of cardiovascular medications. Dr. Kedan reassesses both as OSA treatment takes effect.
How do I schedule a consultation?
Call (310) 304-5555 or use the contact form to schedule with Dr. Kedan at the Beverly Hills office. Cardiolucent does not bill Medicare or insurance; a detailed superbill is provided for any out-of-network reimbursement.

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The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.