The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index; 23 of the 49 sources its claims cite were checked for support.
Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association
Open accessAbstract
Obstructive sleep apnea (OSA) is characterized by recurrent complete and partial upper airway obstructive events, resulting in intermittent hypoxemia, autonomic fluctuation, and sleep fragmentation. Approximately 34% and 17% of middle-aged men and women, respectively, meet the diagnostic criteria for OSA. Sleep disturbances are common and underdiagnosed among middle-aged and older adults, and the prevalence varies by race/ethnicity, sex, and obesity status. OSA prevalence is as high as 40% to 80% in patients with hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, and stroke. Despite its high prevalence in patients with heart disease and the vulnerability of cardiac patients to OSA-related stressors and adverse cardiovascular outcomes, OSA is often underrecognized and undertreated in cardiovascular practice. We recommend screening for OSA in patients with resistant/poorly controlled hypertension, pulmonary hypertension, and recurrent atrial fibrillation after either cardioversion or ablation. In patients with New York Heart Association class II to IV heart failure and suspicion of sleep-disordered breathing or excessive daytime sleepiness, a formal sleep assessment is reasonable. In patients with tachy-brady syndrome or ventricular tachycardia or survivors of sudden cardiac death in whom sleep apnea is suspected after a comprehensive sleep assessment, evaluation for sleep apnea should be considered. After stroke, clinical equipoise exists with respect to screening and treatment. Patients with nocturnally occurring angina, myocardial infarction, arrhythmias, or appropriate shocks from implanted cardioverter-defibrillators may be especially likely to have comorbid sleep apnea. All patients with OSA should be considered for treatment, including behavioral modifications and weight loss as indicated. Continuous positive airway pressure should be offered to patients with severe OSA, whereas oral appliances can be considered for those with mild to moderate OSA or for continuous positive airway pressure-intolerant patients. Follow-up sleep testing should be performed to assess the effectiveness of treatment.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
37 No basis given · 24 No full text of the sources · 14 Partly supported · 12 Own interpretation · 7 Supported · 2 Not checked yet · 1 Supported so far · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Patients without HF diagnosed with OSA have an increased subsequent risk of incident HF. 29”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Heart Failure
What the sources say
- Partly supportedcites [29] 29. Holt A, Bjerre J, Zareini B, Koch H, Tønnesen P, Gislason GH, Nielsen OW, Schou M, Lamberts M. Sleep apnea, the risk of developing heart failure, and potential benefits of continuous positive airway pressure (CPAP) thera- py. J Am Heart Assoc. 2018;7:e008684. doi: 10.1161/JAHA.118.008684 sourceExperimental — accuracy not yet measured
The Methods exclude people with prior heart failure, and the Conclusions report increased incident heart-failure risk among patients with sleep apnea who were not treated with CPAP. However, the study identifies patients by a general sleep-apnea diagnosis, not specifically obstructive sleep apnea, and its conclusion retains the untreated-with-CPAP qualifier. (LLM, conf=0.86)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In general, patients with OSA experienced a reduction in cardiac dysrhythmias when treated with CPAP.24”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Other Arrhythmias
What the sources say
- Partly supportedcites [24] 24. Anter E, Di Biase L, Contreras-Valdes FM, Gianni C, Mohanty S, Tschabrunn CM, Viles-Gonzalez JF, Leshem E, Buxton AE, Kulbak G, et al. Atrial sub- strate and triggers of paroxysmal atrial fibrillation in patients with obstruc- tive sleep apnea. Circ Arrhythm Electrophysiol. 2017;10:e005407. doi: 10.1161/CIRCEP.117.005407 sourceExperimental — accuracy not yet measured
The Discussion (page not supplied) says most observational studies associated CPAP use with reduced recurrence of atrial fibrillation in patients with OSA. That supports a narrower claim than a general reduction in cardiac dysrhythmias from CPAP treatment; the paper also cautions that the observational findings may not generalize and reports a randomized study that did not prevent new-onset AF. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In a metaanalysis of oral appliance treatments (eg, soft-palate lifters, tongue-retaining devices, mandibular advancement appliances), BP reduction was similar to that noted in the meta-analysis of CPAP trials (2-3 mm Hg).18”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Hypertension
What the sources say
- Supportedcites [18] 18. Iftikhar IH, Hays ER, Iverson MA, Magalang UJ, Maas AK. Effect of oral appliances on blood pressure in obstructive sleep apnea: a system- atic review and meta-analysis. J Clin Sleep Med. 2013;9:165-174. doi: 10.5664/jcsm.2420 source
The Discussion reports pooled blood-pressure reductions of 2.40–2.7 mm Hg with oral appliances and explicitly says their effect size was similar to that in a prior CPAP meta-analysis. It cautions that the studies differed in size and OSA severity. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, in a meta-analysis of 2570 patients with HF with reduced ejection fraction and moderate to severe sleep apnea, CSA represented the dominant phenotype in >70% of cases.4”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Heart Failure
What the sources say
- Partly supportedcites [4] 4. Javaheri S, Barbe F, Campos-Rodriguez F, Dempsey JA, Khayat R, Javaheri S, Malhotra A, Martinez-Garcia MA, Mehra R, Pack AI, et al. Sleep apnea: types, mechanisms, and clinical cardiovascular consequences. J Am Coll Cardiol. 2017;69:841-858. doi: 10.1016/j.jacc.2016.11.069 sourceExperimental — accuracy not yet measured
The section “Prevalence of Sleep Apnea in HFrEF, HFpEF, and Acute HF” reports CSA as more common than OSA in two HFrEF groups totaling 2,570 patients; its figures imply roughly 70% CSA among those with moderate-to-severe sleep apnea. But 2,570 is the total number of HFrEF patients, not the number with moderate-to-severe sleep apnea, and the review does not describe these groups as one meta-analysis. No page number is available in our copy. (LLM, conf=0.88)
plainn = 2,570- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“OSA is highly prevalent in hypertensive patients, of whom 30% to 50% will have comorbid OSA. 1”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Hypertension
What the sources say
- Partly supportedcites [1] 1. Tietjens JR, Claman D, Kezirian EJ, De Marco T, Mirzayan A, Sadroonri B, Goldberg AN, Long C, Gerstenfeld EP, Yeghiazarians Y. Obstructive sleep apnea in cardiovascular disease: a review of the literature and pro- posed multidisciplinary clinical management strategy. J Am Heart Assoc. 2019;8:e010440. doi: 10.1161/JAHA.118.010440 sourceExperimental — accuracy not yet measured
The Resistant Hypertension section reports OSA in 38% of patients with essential hypertension, which falls within the claimed range. It also reports 71% in patients with resistant hypertension, so the review does not support applying 30%–50% to hypertensive patients generally. No page number is available in our copy. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In one report, polysomnographic studies showed 58% of patients with implanted pacemakers for sick sinus syndrome had previously undiagnosed sleep apnea syndrome.26”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Other Arrhythmias
What the sources say
- Supportedcites [26] 26. Garrigue S, Pépin JL, Defaye P, Murgatroyd F, Poezevara Y, Clémenty J, Lévy P. High prevalence of sleep apnea syndrome in patients with long- term pacing: the European Multicenter Polysomnographic Study. Circulation. 2007;115:1703-1709. doi: 10.1161/CIRCULATIONAHA.106.659706 source
The Abstract reports that patients not known to have sleep apnea underwent polysomnography and that 58% of those paced for sinus node disease had sleep apnea syndrome. The Study Population section confirms that these patients had implanted pacemakers for symptomatic sinus node dysfunction. (LLM, conf=0.94)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, large randomized controlled trials have not yet shown an effect of PAP, including CPAP, on survival.13,30”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Mortality
What the sources say
- Not checked — no full text of the sourcecites [13] 13. McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, Zhang X, Mediano O, Chen R, Drager LF, Liu Z, et al; SAVE Investigators and Coordinators. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med. 2016;375:919-931. doi: 10.1056/NEJMoa1606599 source
- Supportedcites [30] 30. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treat- ment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2019;15:301-334. doi: 10.5664/jcsm.7638 source
The All-Cause Mortality section reports that four RCTs assessed mortality and that their meta-analysis did not demonstrate a clinically significant reduction with PAP. It also says the largest trial found no clinically significant mortality impact from CPAP. The review cautions that the overall evidence is inconclusive; it does not establish that PAP has no survival effect. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Although there is no consensus that screening for OSA in primary care clinics significantly alters clinical outcomes, 12 no study has specifically tested this question.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SCREENING
What the sources say
- Supportedcites [12] 12. Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, García FA, Herzstein J, Kemper AR, Krist AH, Kurth AE, et al. Screening for obstructive sleep apnea in adults: US Preventive Services Task Force recommendation statement. JAMA. 2017;317:407-414. doi: 10.1001/jama.2016.20325 source
The “Effectiveness of Early Detection and Treatment” section (page not provided) states that the USPSTF found no studies directly evaluating whether OSA screening affects health outcomes. This supports the claim about screening in primary care; the paper separately discusses treatment studies, which do not test screening itself. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Undiagnosed cases are particularly prevalent in Black patients.11”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SCREENING
What the sources say
- Supportedcites [11] 11. Johnson DA, Thomas SJ, Abdalla M, Guo N, Yano Y, Rueschman M, Tanner RM, Mittleman MA, Calhoun DA, Wilson JG, et al. Association be- tween sleep apnea and blood pressure control among Blacks. Circulation. 2019;139:1275-1284. doi: 10.1161/CIRCULATIONAHA.118.036675 source
The Discussion reports that moderate or severe OSA was common among Black participants with hypertension and largely undiagnosed: only 6% of those with OSA reported a previous diagnosis. The introductory passage also reports that 84% of Black MESA participants with sleep-disordered breathing did not report a physician diagnosis. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“OSA has been associated with a greater likelihood of the metabolic syndrome and type 2 diabetes, independently of adiposity level.46”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Metabolic Syndrome and Type 2 Diabetes
What the sources say
- Partly supportedcites [46] 46. Xu S, Wan Y, Xu M, Ming J, Xing Y, An F, Ji Q. The association between obstructive sleep apnea and metabolic syndrome: a systematic re- view and meta-analysis. BMC Pulm Med. 2015;15:105. doi: 10.1186/ s12890-015-0102-3 sourceExperimental — accuracy not yet measured
The Background reports associations of OSA with both metabolic syndrome and type 2 diabetes, and the Results find greater odds of metabolic syndrome among people with OSA. But the Discussion says obesity was adjusted for in only 12 of 20 included studies and was assessed only by BMI. The paper does not establish that the type 2 diabetes association is independent of adiposity, so the sentence extends that qualifier beyond the evidence presented. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
- It may state two separate claims as one. 45
- Probably not a substantial claim. 11
- The quote only partly states this claim. 2
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A meta-analysis of 16 studies and 24 308 individuals showed that severe OSA (AHI ≥30) was associated with increased all-cause and cardiovascular mortality.48”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Mortality
What the sources say
- Partly supportedcites [48] 48. Xie C, Zhu R, Tian Y, Wang K. Association of obstructive sleep apnoea with the risk of vascular outcomes and all-cause mortality: a meta-analysis. BMJ Open. 2017;7:e013983. doi: 10.1136/bmjopen-2016-013983 sourceExperimental — accuracy not yet measured
The Abstract Results report 16 cohort studies with 24,308 individuals and increased all-cause mortality and cardiac death associated with severe OSA. The Methods (Statistical analysis) define severe OSA as AHI >30, not AHI ≥30 as claimed; the reported mortality outcome is specifically cardiac death. (LLM, conf=0.85)
plaincorrelationaln = 24,308- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A recent meta-analysis found a prevalence of poststroke OSA of 71%, with similar findings across acute, subacute, and chronic time points.36”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Cerebrovascular Disease
What the sources say
- Partly supportedcites [36] 36. Seiler A, Camilo M, Korostovtseva L, Haynes AG, Brill AK, Horvath T, Egger M, Bassetti CL. Prevalence of sleep-disordered breathing after stroke and TIA: a meta-analysis. Neurology. 2019;92:e648-e654. doi: 10.1212/WNL.0000000000006904 sourceExperimental — accuracy not yet measured
The Abstract (page not provided) reports a 71% prevalence of sleep-disordered breathing after stroke or TIA and says its prevalence was similar in the acute, subacute, and chronic phases. It does not identify that 71% as the prevalence of obstructive sleep apnea specifically; the Study characteristics section (page not provided) separately reports central sleep apnea. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Even in patients with OSA with resistant hypertension, a 3-month treatment with CPAP (versus no CPAP) reduced 24-hour systolic, mean, and diastolic BPs by ≈3 mm Hg, with a significant correlation between hours of CPAP use and BP reduction.17”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Hypertension
What the sources say
- Partly supportedcites [17] 17. Martínez-García MA, Capote F, Campos-Rodríguez F, Lloberes P, Díaz de Atauri MJ, Somoza M, Masa JF, González M, Sacristán L, Barbé F, et al; Span- ish Sleep Network. Effect of CPAP on blood pressure in patients with obstruc- tive sleep apnea and resistant hypertension: the HIPARCO randomized clini- cal trial. JAMA. 2013;310:2407-2415. doi: 10.1001/jama.2013.281250 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In a 15-year longitudinal follow-up study of 10 071 adults, OSA predicted incident sudden cardiac death, with the best predictors being age >60 years, mean nocturnal oxygen saturation <78%, and AHI >20.27”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Other Arrhythmias
What the sources say
- Partly supportedcites [27] 27. Gami AS, Olson EJ, Shen WK, Wright RS, Ballman KV, Hodge DO, Herges RM, Howard DE, Somers VK. Obstructive sleep apnea and the risk of sud- den cardiac death: a longitudinal study of 10,701 adults. J Am Coll Cardiol. 2013;62:610-616. doi: 10.1016/j.jacc.2013.04.080 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Although several small-scale studies have reported benefits associated with CPAP, including improved left ventricular function, reduced sympathetic tone and myocardial oxygen consumption, and lower rates of HF hospitalization and mortality, a meta-analysis of patients with OSA reported that CPAP did not have significant effects on either left ventricular ejection fraction or hospitalization rates.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Heart Failure
What the sources say
- Supportedcites [30] 30. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treat- ment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2019;15:301-334. doi: 10.5664/jcsm.7638 source
The Left Ventricle Ejection Fraction section reports no clinically significant improvement with PAP in adults with OSA, including analyses with and without heart failure. The Hospitalization section reports no significant reduction in all-cause hospitalizations with PAP, while noting that only two non-randomized studies were available and the evidence quality was very low. The paper specifies clinical significance for LVEF rather than stating that its result was statistically nonsignificant. (LLM, conf=0.88)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In contrast to isolated OSA, patients with obesity hypoventilation syndrome, which is characterized by awake hypercapnia (Paco 2 >45 mm Hg) and obesity, commonly develop moderate to severe PH and higher risk of adverse outcomes, including cor pulmonale and death.45”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Pulmonary Hypertension
What the sources say
- Partly supportedcites [45] 45. Masa JF, Pépin JL, Borel JC, Mokhlesi B, Murphy PB, Sánchez-Quiroga M. Obesity hypoventilation syndrome. Eur Respir Rev. 2019;28:180097. doi: 10.1183/16000617.0097-2018 sourceExperimental — accuracy not yet measured
The Comorbidities section says pulmonary hypertension affects about half of patients with OHS and reports elevated mortality. The Clinical presentation and diagnosis section says cor pulmonale is more likely in OHS than in eucapnic OSA. The source does not establish that the pulmonary hypertension commonly developed is moderate to severe. (LLM, conf=0.88)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“PH related to OSA is generally mild in the absence of additional cardiopulmonary disease, with average mean pulmonary artery pressure between 25 and 30 mm Hg and rarely exceeding 35 mm Hg. 43”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Pulmonary Hypertension
What the sources say
- Partly supportedcites [43] 43. Kholdani C, Fares WH, Mohsenin V. Pulmonary hypertension in obstructive sleep apnea: is it clinically significant? A critical analysis of the association and pathophysiology. Pulm Circ. 2015;5:220-227. doi: 10.1086/679995 sourceExperimental — accuracy not yet measured
The “Effect of Treatment of OSA on PH” section reports a mean pulmonary artery pressure of 25.6 mm Hg in six patients with OSA and PH, and discusses treating mild-to-moderate PH. It does not establish 25–30 mm Hg as the general average in patients without additional cardiopulmonary disease or state that pressure rarely exceeds 35 mm Hg. (LLM, conf=0.84)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Central adiposity is linked to the development of both OSA and the metabolic syndrome, with both sharing similar pathophysiological features (eg, systemic inflammation, endothelial dysfunction).47”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Metabolic Syndrome and Type 2 Diabetes
What the sources say
- Partly supportedcites [47] 47. Drager LF, Togeiro SM, Polotsky VY, Lorenzi-Filho G. Obstructive sleep ap- nea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol. 2013;62:569-576. doi: 10.1016/j.jacc.2013.05.045 sourceExperimental — accuracy not yet measured
The review’s Abstract links obesity to OSA and reports systemic inflammation and endothelial dysfunction in obese patients with OSA. Its discussion of why OSA is common in obesity and metabolic syndrome also describes a role for abdominal fat in airway narrowing. However, the cited passages do not establish that central adiposity contributes to the development of metabolic syndrome or that both conditions share the two named features. (LLM, conf=0.83)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“OSA is widely underdiagnosed; 86% to 95% of individuals found in population surveys with clinically significant OSA report no prior OSA diagnosis.5”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SCREENING
What the sources say
- Partly supportedcites [5] 5. Chen X, Wang R, Zee P, Lutsey PL, Javaheri S, Alcántara C, Jackson CL, Williams MA, Redline S. Racial/ethnic differences in sleep disturbances: the Multi-Ethnic Study of Atherosclerosis (MESA). Sleep. 2015;38:877-888. doi: 10.5665/sleep.4732 sourceExperimental — accuracy not yet measured
The Sleep Disordered Breathing section reports that 84%–93% of MESA participants with moderately or severely elevated apnea-hypopnea index levels were undiagnosed, supporting the point that sleep apnea is substantially underdiagnosed. It does not report the claimed 86%–95% range, and that estimate comes from the MESA cohort rather than population surveys generally. Page numbers are unavailable in our copy. (LLM, conf=0.90)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In observational studies that examined several modalities of PAP, a significant mortality reduction was observed with PAP, with greater risk reduction observed among patients with HF. 30”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Mortality
What the sources say
- Supportedcites [30] 30. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treat- ment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2019;15:301-334. doi: 10.5664/jcsm.7638 source
In All-Cause Mortality, the review reports that a meta-analysis of nine non-randomized studies found lower mortality associated with PAP (risk ratio 0.40, 95% CI 0.24–0.69). Its subgroup estimates show a larger risk reduction among participants with heart failure (0.2) than among those without (0.4). The review also cautions that the overall evidence on whether PAP reduces mortality is inconclusive. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“OSA is not only an independent risk factor for incident stroke 37 but also an independent risk factor for stroke recurrence, 38 mortality, and functional and cognitive outcomes.39”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Cerebrovascular Disease
What the sources say
- Not checked — no full text of the sourcecites [37] 37. Loke YK, Brown JW, Kwok CS, Niruban A, Myint PK. Association of obstruc- tive sleep apnea with risk of serious cardiovascular events: a systematic re- view and meta-analysis. Circ Cardiovasc Qual Outcomes. 2012;5:720-728. doi: 10.1161/CIRCOUTCOMES.111.964783 source
- Supportedcites [38] 38. Brown DL, Shafie-Khorassani F, Kim S, Chervin RD, Case E, Morgenstern LB, Yadollahi A, Tower S, Lisabeth LD. Sleep-disordered breathing is as- sociated with recurrent ischemic stroke. Stroke. 2019;50:571-576. doi: 10.1161/STROKEAHA.118.023807 source
Citation 38 is attached to the stroke-recurrence claim, not the separately cited claims about incident stroke, mortality, or other outcomes. The Results section reports that sleep-disordered breathing was associated with recurrent ischemic stroke after adjustment for potential confounders; the Introduction notes that post-stroke sleep-disordered breathing is predominantly obstructive sleep apnea. Page numbers were not available in our copy. (LLM, conf=0.90)
- Partly supportedcites [39] 39. Lisabeth LD, Sánchez BN, Lim D, Chervin RD, Case E, Morgenstern LB, Tower S, Brown DL. Sleep-disordered breathing and poststroke outcomes. Ann Neurol. 2019;86:241-250. doi: 10.1002/ana.25515 sourceExperimental — accuracy not yet measured
The Results section (SDB and Ninety-day Stroke Outcomes; page unavailable) reports adjusted associations between sleep-disordered breathing and worse functional and cognitive outcomes 90 days after stroke. It does not establish an independent risk of mortality; the Study Participants section says patients who died before 90 days were excluded from the outcome analysis. The incident-stroke and recurrence claims have separate citations in the citing sentence. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In an analysis from the Sleep Heart Healthy Study, a PAP prescription was associated with 42% lower mortality among patients with severe OSA, but this risk reduction was not seen until 6 to 7 years of follow-up.49”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Mortality
What the sources say
- Not checked — no full text of the sourcecites [49] 49. Lisan Q, Van Sloten T, Marques Vidal P, Haba Rubio J, Heinzer R, Empana JP. Association of positive airway pressure prescription with mortality in pa- tients with obesity and severe obstructive sleep apnea: the Sleep Heart Health Study. JAMA Otolaryngol Head Neck Surg. 2019;145:509-515. doi: 10.1001/jamaoto.2019.0281 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The overall prevalence of sleep-disordered breathing among patients with symptomatic HF is 40% to 60%, with OSA making up approximately one-third of the cases.28”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Heart Failure
What the sources say
- Not checked — no full text of the sourcecites [28] 28. Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, Töpfer V. Sleep- disordered breathing in patients with symptomatic heart failure: a contem- porary study of prevalence in and characteristics of 700 patients. Eur J Heart Fail. 2007;9:251-257. doi: 10.1016/j.ejheart.2006.08.003 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a population-based cohort study of 690 subjects, a 10% weight gain was associated with a nearly 32% increase in the apnea-hypopnea index (AHI), and even modest weight control was effective in reducing the new occurrence of sleep-disordered breathing.6”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Abstract
What the sources say
- Not checked — no full text of the sourcecites [6] 6. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA. 2000;284:3015-3021. doi: 10.1001/jama.284.23.3015 source
plaincorrelationaln = 690- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Multiple small and mostly retrospective observational studies have assessed the ability of CPAP to reduce AF burden after ablation or cardioversion.23 Although limited by methodological issues and small sample size, these studies largely support the view that CPAP therapy improves AF burden.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Atrial Fibrillation
What the sources say
- Not checked — no full text of the sourcecites [23] 23. Patel N, Donahue C, Shenoy A, Patel A, El-Sherif N. Obstructive sleep ap- nea and arrhythmia: a systemic review. Int J Cardiol. 2017;228:967-970. doi: 10.1016/j.ijcard.2016.11.137 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In a randomized proof-of-concept study of 60 patients with resistant hypertension and moderate to severe OSA, renal denervation significantly decreased in-office and ambulatory BP at 3 and 6 months after the procedure, with modest reductions in OSA severity.21”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Hypertension
What the sources say
- Not checked — no full text of the sourcecites [21] 21. Warchol-Celinska E, Prejbisz A, Kadziela J, Florczak E, Januszewicz M, Michalowska I, Dobrowolski P, Kabat M, Sliwinski P, Klisiewicz A, et al. Renal denervation in resistant hypertension and obstructive sleep apnea: random- ized proof-of-concept phase II trial. Hypertension. 2018;72:381-390. doi: 10.1161/HYPERTENSIONAHA.118.11180 source
plaindirectn = 60- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Spironolactone in a small randomized controlled trial reduced the severity of OSA and lowered BP in patients with resistant hypertension.20”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Hypertension
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Yang L, Zhang H, Cai M, Zou Y, Jiang X, Song L, Liang E, Bian J, Wu H, Hui R. Effect of spironolactone on patients with resistant hypertension and obstructive sleep apnea. Clin Exp Hypertens. 2016;38:464-468. doi: 10.3109/10641963.2015.1131290 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“OSA has been associated with a number of cardiovascular complications, including hypertension, AF and other arrhythmias, HF, coronary artery disease, stroke, PH, metabolic syndrome, diabetes, and cardiovascular mortality (Figure 2).”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > CARDIOVASCULAR COMPLICATIONS OF OSA
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The Epworth Sleepiness Scale, which focuses on the single problem of propensity for dozing, has higher specificity (67%) but low sensitivity (42%) 14 and is therefore a poor screening tool.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SCREENING
What the sources say
- Not checked — no full text of the sourcecites [14] 14. Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ, Wang YC, Guilleminault C. Diagnostic accuracy of the Berlin questionnaire, STOP- BANG, STOP, and Epworth Sleepiness Scale in detecting obstructive sleep apnea: a bivariate meta-analysis. Sleep Med Rev. 2017;36:57-70. doi: 10.1016/j.smrv.2016.10.004 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“OSA has been linked to an increased risk of job-related and motor vehicle accidents, more frequent health-related missed workdays, and decreased quality of life.8”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > CLINICAL MANIFESTATIONS
What the sources say
- Not checked — no full text of the sourcecites [8] 8. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular out- comes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046-1053. doi: 10.1016/S0140-6736(05)71141-7 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although CPAP has been shown to lower BP and markers of sympathetic activation, it has not been demonstrated to affect lipid levels, glycemic control, or rates of metabolic syndrome or diabetes.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Metabolic Syndrome and Type 2 Diabetes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Recent research identified hypoxia burden as a predictor for increased cardiovascular disease (CVD) risk 10 with other polysomnography-derived measures (eg, loop gain, neuromuscular collapsibility) useful for identifying subgroups who may respond differently to alternative OSA treatments.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > DIAGNOSTIC EVALUATION
What the sources say
- Not checked — no full text of the sourcecites [10] 10. Azarbarzin A, Sands SA, Stone KL, Taranto-Montemurro L, Messineo L, Terrill PI, Ancoli-Israel S, Ensrud K, Purcell S, White DP, et al. The hypoxic burden of sleep apnoea predicts cardiovascular disease-related mortality: the Osteoporotic Fractures in Men Study and the Sleep Heart Health Study. Eur Heart J. 2019;40:1149-1157. doi: 10.1093/eurheartj/ehy624 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“CPAP trials in patients after stroke, although challenged by treatment adherence, have shown promise for stroke recovery and secondary prevention.40”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Cerebrovascular Disease
What the sources say
- Not checked — no full text of the sourcecites [40] 40. Brill AK, Horvath T, Seiler A, Camilo M, Haynes AG, Ott SR, Egger M, Bassetti CL. CPAP as treatment of sleep apnea after stroke: a meta- analysis of randomized trials. Neurology. 2018;90:e1222-e1230. doi: 10.1212/WNL.0000000000005262 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Mooe et al 33 have shown that the severity of hypoxemia is a major determinant of ST depression occurring during sleep, and in patients with OSA, the onset of MI is more likely to occur during the nighttime.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Coronary Artery Disease
What the sources say
- Not checked — no full text of the sourcecites [33] 33. Mooe T, Franklin KA, Wiklund U, Rabben T, Holmström K. Sleep-disordered breathing and myocardial ischemia in patients with coronary artery disease. Chest. 2000;117:1597-1602. doi: 10.1378/chest.117.6.1597 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Patients with PH with OSA have increased hypoxia-induced pulmonary vascular reactivity, and CPAP treatment reduces hypoxic vascular reactivity.44”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Pulmonary Hypertension
What the sources say
- Not checked — no full text of the sourcecites [44] 44. Sajkov D, Wang T, Saunders NA, Bune AJ, Mcevoy RD. Continuous positive airway pressure treatment improves pulmonary hemodynamics in patients with obstructive sleep apnea. Am J Respir Crit Care Med. 2002;165:152- 158. doi: 10.1164/ajrccm.165.2.2010092 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“10% weight loss reduces AHI by 26%”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
direct- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Long-term adherence is low (10%) 50 because of discomfort.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It appears that neck circumference remains an independent predictor of OSA even after accounting for body mass index and may even provide stronger correlation with select disease severity measures such as Sao 2 nadir and AHI in patients with OSA than body mass index.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Abstract
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Morphological abnormalities are the most common factors contributing to upper airway obstruction.Examples include retrognathia, enlarged tonsils, and increased soft tissue in the neck.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > PATHOPHYSIOLOGY
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Daytime exercise routines can prevent rostral redistribution of fluid, resulting in modest improvements in AHI”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although OSA increases the risk of all-cause and cardiovascular mortality, this condition is often underrecognized and undertreated in cardiovascular practice.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Normal sleep-related physiological phenomena influence respiratory mechanics.These include, but are not limited to, reduced pharyngeal caliber, decreased muscle activity, heightened upper airway resistance, impaired respiratory load compensation, and a slight (5 mm Hg) increase in arterial carbon dioxide.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > PATHOPHYSIOLOGY
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although OSA increases the risk of all-cause and cardiovascular mortality, this condition is often underrecognized and undertreated in cardiovascular practice.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although CPAP has been the mainstay of therapy, this device is far from perfect and has limited adherence.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > FUTURE DIRECTIONS AND AREAS FOR RESEARCH
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Newer-generation devices deliver a subtle vibrating stimulus to serve as negative reinforcement for supine sleep and associated with high short-term adherence.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“40%-80% adherence defined as use for ≥4 h per night for 70% of the period of use.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Trials have not consistently shown improved adherence compared with CPAP or inferiority to CPAP”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Craniofacial anatomic abnormalities can narrow the upper airway and represent important risk factors for OSA that can be quantified with the modified Mallampati classification.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Rarely curative but may improve clinical outcomes (eg, mortality, cardiovascular risk, motor vehicle accidents, function, quality of life, symptoms)”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Certain substances appear to exacerbate preexisting OSA but not cause it (eg, alcohol, benzodiazepines, and opiates).”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Abstract
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Clinical trials have shown improvement in BP, improvement in subjective sleepiness or dozing propensity (ESS), and improvement in quality of life”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Additional less well-established risk factors include smoking, family history of OSA, and nighttime nasal congestion.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Improvement in BP and sleepiness”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Wearable technologies are progressively being adopted as diagnostic tools but need more validation.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > DIAGNOSTIC EVALUATION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“The 2017 American Heart Association/American College of Cardiology HF guideline identified CPAP as a possibly reasonable treatment strategy (Class IIb) to improve sleep quality and daytime sleepiness in patients with CVD and OSA. 31”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Heart Failure
What the sources say
- Not checked — no full text of the sourcecites [31] 31. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos GS, Fonarow GC, Givertz MM, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/Ameri- can Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Circulation. 2017;136:e137-e161. doi: 10.1161/CIR.0000000000000509 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The risk of OSA correlates with body mass index, and obesity remains the one major modifiable risk factor for OSA.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Obesity is a modifiable risk factor for obstructive sleep apnea.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Improves 24-h ambulatory BP measures and markers of inflammation”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, clinical equipoise currently exists with respect to OSA treatment and screening after stroke, and it should be kept in mind that signs and symptoms of OSA are not predictive in patients with stroke.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > Cerebrovascular Disease
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Screening instruments may underperform in certain groups, including women, who more commonly report fatigue and insomnia symptoms than sleepiness, and in patients with underlying CVD, HF, or AF and those after stroke.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SCREENING
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mandibular devices and neural stimulation strategies may provide viable alternatives to CPAP.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > FUTURE DIRECTIONS AND AREAS FOR RESEARCH
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Chemoreceptor modulation to attenuate OSA or its consequences is still experimental, as are pharmacologic therapeutic options for OSA.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > FUTURE DIRECTIONS AND AREAS FOR RESEARCH
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Reduction in AHI”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Improvement in patient-reported outcomes”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients with nocturnally occurring angina, MI, arrhythmias, or appropriate shocks from implanted cardioverter-defibrillators may be especially likely to have comorbid sleep apnea.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After stroke, clinical equipoise exists with respect to screening and treatment.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Women and those who are older appear to be more responsive.”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > SUMMARY RECOMMENDATIONS
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper relies on this without support.
Obesity is a modifiable risk factor for obstructive sleep apnea.
“The risk of OSA correlates with body mass index, and obesity remains the one major modifiable risk factor for OSA.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“OSA and OA may also compound the cardiovascular risk of obesity by contributing to elevations in blood pressure 10 , 11 and high‐sensitivity C‐reactive protein, a sensitive marker of cardiovascular risk. 12 , 13”
From Retatrutide for the treatment of obesity, obstructive sleep apnea and knee osteoarthritis: Rationale and design of the TRIUMPH registrational clinical trials (2026) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“MBS, the most potent weight loss therapy, has become safer, with less invasive surgical options over time.20,21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Obstructive sleep apnea (OSA) is a common condition strongly linked to increased cardiovascular risk and poor glycemic control.”
From Obstructive Sleep Apnea, Resting Heart Rate, and Glycemic Variability in Adults With Maturity-Onset Diabetes of the Young (2026) · cites this paper as [1]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Regular assessments of lipids, glycemia, and kidney function (eg, eGFR) are recommended with increasing frequency for higher CKM stages, as the risk for progressive metabolic and kidney disease increases along the CKM spectrum.13,18–21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Evidence also supports cardiac biomarker testing based on age and CKM risk factors (eg, age ≥40 years and at least 1 CKM risk factor as in STOP-HF7); however, such an approach has a lower yield than a strategy guided by an integrated measure of HF risk (PREVENT-HF).19,20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measured
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Through these mechanisms, adverse SDOH lead to CKM risk factor development.16–20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Adverse SDOH contribute to increased risk for CVD and all-cause mortality in people with CKM syndrome.20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Greater amounts of intentional weight loss are associated with more substantial improvement in CKM risk factors,20 with some possible reductions in CVD risk with ≥10% weight loss.21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“CKM risk factor remission is superior with RYGB bypass compared with LSG.20,21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Counseling on dietary or combined dietary and exercise modifications effectively facilitates weight loss in postpartum women with GDM.6,19–21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“RCTs suggest that atorvastatin may reduce progression of CKD.19,20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Notably, these studies represent simulations of RCT results applied to epidemiologic studies with dropin of preventive therapies affecting event rates20 and do not indicate the order for adding therapies.”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Semaglutide was also associated with an average 9% reduction in weight over 4 years of follow-up”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“reductions in cardiovascular events regardless of baseline HbA1c”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“with significant improvements in cardiometabolic endpoints, systemic inflammation, and reductions in cardiovascular events regardless of baseline HbA1c”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“GLP-1–based therapy often causes significant weight loss and improvements in CKM risk profiles and MASLD, while SGLT2i has a marked impact on CKD.19–30”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“STEP-HFpEF and STEP-HFpEF DM participants who were already prescribed loop diuretics experienced the greatest improvement in KCCQ-CSS with semaglutide, and semaglutide was associated with lesser diuretic dose requirements.20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Both SGLT2i and GLP-1–based therapy improve kidney outcomes,49–51 with GLP-1–based therapy additionally promoting significant weight reduction and glycemic control (especially semaglutide and tirzepatide)19–25 and reducing liver fibrosis in MASH”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“While there is growing evidence for GLP-1 benefit in HFpEF, there is less clarity regarding efficacy and safety in HFrEF, based on somewhat increased risk for adverse outcomes among patients taking GLP-1 RA in small HFrEF trials.19–21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Assessment of fibrosis risk starts with the FIB-4 index, with further sequential assessments as needed to rule out (or rule in) clinically significant fibrosis (≥ stage 2).19–21”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Statins are safe and effective in patients with MASLD and should be used according to guidelines.12,19,20,27”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“a lower eGFR, higher UACR, and higher CKD stages are associated with VTE development and worse outcomes.16–20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Guidelines from the American Association for the Study of Liver Diseases recommend the FIB-4 as the preferred noninvasive screening test due to its high negative predictive value.20”
From 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome (2026) · cites this paper as [20]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > DIAGNOSTIC EVALUATION
“Empirical categorization is based on AHI or Respiratory Event Index of 5 to <15 (mild), 15 to 30 (moderate), and >30 (severe).9”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > CARDIOVASCULAR COMPLICATIONS OF OSA
“Mild AHI ≥5-15 Moderate AHI ≥15-30 Severe AHI ≥30”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > DIAGNOSTIC EVALUATION
“Empirical categorization is based on AHI or Respiratory Event Index of 5 to <15 (mild), 15 to 30 (moderate), and >30 (severe).”
§ Obstructive Sleep Apnea and Cardiovascular Disease A Scientific Statement From the American Heart Association > CARDIOVASCULAR COMPLICATIONS OF OSA
“Mild AHI ≥5-15 Moderate AHI ≥15-30 Severe AHI ≥30”
Citations
Cites
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678
Increased Prevalence of Sleep-Disordered Breathing in Adults
Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws342 · Cited by 4,618
Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6506 · Cited by 3,253
Self-citationYancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Colvin, M. M., Drazner, M. H., Filippatos, G. S., Fonarow, G. C., Givertz, M. M., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000509 · Cited by 3,109
Self-citationCPAP for Prevention of Cardiovascular Events in Obstructive Sleep Apnea
McEvoy, R. D., Antic, N. A., Heeley, E., Luo, Y., Ou, Q., Zhang, X., Mediano, O., Chen, R., Drager, L. F., Liu, Z., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1606599 · Cited by 2,101
Self-citationLongitudinal Study of Moderate Weight Change and Sleep-Disordered Breathing
Peppard, P. E. (2000) · JAMA · doi:10.1001/jama.284.23.3015 · Cited by 2,020
Sleep Apnea and Cardiovascular Disease
Somers, V. K., White, D. P., Amin, R. S., Abraham, W. T., Costa, F., Culebras, A., Daniels, S. R., Floras, J. S., Hunt, C. E., Olson, L. J., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.05.002 · Cited by 1,530
Self-citationGoldberger, J. J., Cain, M. E., Hohnloser, S. H., Kadish, A. H., Knight, B. P., Lauer, M. S., Maron, B. J., Page, R. L., Passman, R. S., Siscovick, D., et al. (2008) · Circulation · doi:10.1161/circulationaha.107.189375 · Cited by 1,450
Javaheri, S., Barbe, F., Campos-Rodriguez, F., Dempsey, J. A., Khayat, R., Javaheri, S., Malhotra, A., Martinez-Garcia, M. A., Mehra, R., Pack, A. I., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.11.069 · Cited by 1,434
Self-citationSleep Apnea and Cardiovascular Disease
Somers, V. K., White, D. P., Amin, R. S., Abraham, W. T., Costa, F., Culebras, A., Daniels, S. R., Floras, J. S., Hunt, C. E., Olson, L. J., et al. (2008) · Circulation · doi:10.1161/circulationaha.107.189420 · Cited by 1,347
Self-citation
Cited by
Sorted by citations
Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity
Malhotra, A., Grunstein, R. R., Fietze, I., Weaver, T. E., Redline, S., Azarbarzin, A., Sands, S. A., Schwab, R. J., Dunn, J. P., Chakladar, S., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2404881 · Cited by 871
Self-citationPathophysiological mechanisms and therapeutic approaches in obstructive sleep apnea syndrome
Lv, R., Liu, X., Zhang, Y., Dong, N., Wang, X., He, Y., Yue, H., & Yin, Q. (2023) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01496-3 · Cited by 555
Bushnell, C., Kernan, W. N., Sharrief, A. Z., Chaturvedi, S., Cole, J. W., Cornwell, W. K., Cosby-Gaither, C., Doyle, S., Goldstein, L. B., Lennon, O. C., et al. (2024) · Stroke · doi:10.1161/str.0000000000000475 · Cited by 443
Thompson, A., Fleischmann, K. E., Smilowitz, N. R., Fuentes, L. D. L., Mukherjee, D., Aggarwal, N. R., Ahmad, F. S., Allen, R. B., Altin, S. E., Auerbach, A. D., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001285 · Cited by 446
The importance of healthy lifestyle behaviors in the prevention of cardiovascular disease
Kaminsky, L. A., German, C. A., Imboden, M. T., Ozemek, C., Peterman, J. E., & Brubaker, P. H. (2021) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2021.12.001 · Cited by 359
Gottesman, R. F., Lutsey, P. L., Benveniste, H., Brown, D. L., Full, K. M., Lee, J., Osorio, R. S., Pase, M. P., Redeker, N. S., Redline, S. S., et al. (2024) · Stroke · doi:10.1161/str.0000000000000453 · Cited by 276
“For instance, there is a link between OSA and hypertension, 69 a factor that contributes to the progression of cerebral small vessel disease, making it challenging to separate the direct effects of OSA on cognitive decline.”
BackgroundInfluentialSelf-citationThompson, A., Fleischmann, K. E., Smilowitz, N. R., Fuentes, L. D. L., Mukherjee, D., Aggarwal, N. R., Ahmad, F. S., Allen, R. B., Altin, S. E., Auerbach, A. D., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.06.013 · Cited by 257
Bidirectional relationships of comorbidity with obstructive sleep apnoea
Gleeson, M., & McNicholas, W. T. (2022) · European Respiratory Review · doi:10.1183/16000617.0256-2021 · Cited by 203
Mehra, R., Chung, M. K., Olshansky, B., Dobrev, D., Jackson, C. L., Kundel, V., Linz, D., Redeker, N. S., Redline, S. S., Sanders, P., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001082 · Cited by 160
Self-citationInteractions of Obstructive Sleep Apnea With the Pathophysiology of Cardiovascular Disease, Part 1
Javaheri, S., Javaheri, S., Somers, V. K., Gozal, D., Mokhlesi, B., Mehra, R., McNicholas, W. T., Zee, P. C., Campos‐Rodríguez, F., Martínez‐García, M. Á., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.02.059 · Cited by 173
Self-citationSleep apnoea and ischaemic stroke: current knowledge and future directions
Baillieul, S., Dekkers, M., Brill, A.-K., Schmidt, M. H., Detante, O., Pépin, J., Tamisier, R., & Bassetti, C. L. A. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00321-5 · Cited by 140
The Role of Sleep in Cardiovascular Disease
Jaspan, V. N., Greenberg, G. S., Parihar, S., Park, C. M., Somers, V. K., Shapiro, M. D., Lavie, C. J., Virani, S. S., & Slipczuk, L. N. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01207-5 · Cited by 150
Self-citationThe Global Burden of Obstructive Sleep Apnea
Iannella, G., Pace, A., Bellizzi, M. G., Magliulo, G., Greco, A., VIRGILIO, A. D., Croce, E., Gioacchini, F. M., Re, M., Costantino, A., et al. (2025) · Diagnostics · doi:10.3390/diagnostics15091088 · Cited by 150
“Although this phenotyping method holds promise for individualized CPAP protocols [147], considerable hurdles remain with respect to algorithmic fairness and equitable healthcare access [148], which call for creative solutions for underserved individuals.”
St‐Onge, M., Aggarwal, B., Fernández‐Mendoza, J., Johnson, D. A., Kline, C. E., Knutson, K. L., Redeker, N. S., & Grandner, M. A. (2025) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/hcq.0000000000000139 · Cited by 127
Sleep apnoea and ischaemic stroke: current knowledge and future directions.
Baillieul, S., Dekkers, M. P. J., Brill, A., Schmidt, M. H., Detante, O., Pépin, J., Tamisier, R., & Bassetti, C. L. (2022) · doi:10.48350/163559 · Cited by 100
Wang, X., Fan, J., Guo, R., Hao, W., Gong, W., Yan, Y., Zheng, W., Ai, H., Que, B., Hu, D., et al. (2022) · European Respiratory Journal · doi:10.1183/13993003.01110-2022 · Cited by 93
“OSA is associated with oxidative stress, sympathetic activation, inflammatory responses and endothelial dysfunction that could induce or exacerbate cardiovascular comorbidities [2, 3], including acute coronary syndrome (ACS) [4].”
Self-citationCognitive Impairment in Heart Failure: A Heart Failure Society of America Scientific Statement
Goyal, P., DiDomenico, R. J., Pressler, S. J., Ibeh, C., White‐Williams, C., Allen, L. A., Gorodeski, E. Z., Albert, N. M., Fudim, M., Lekavich, C. L., et al. (2024) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2024.01.003 · Cited by 94
Shiina, K. (2024) · Hypertension Research · doi:10.1038/s41440-024-01852-y · Cited by 104
A flexible catheter-based sensor array for upper airway soft tissues pressure monitoring
Shang, J., Ma, X., Zou, P., Huang, C., Lao, Z., Wang, J., Jiang, T., Fu, Y., Li, J., Zhang, S., et al. (2025) · Nature Communications · doi:10.1038/s41467-024-55088-y · Cited by 86
Evaluating ChatGPT responses on obstructive sleep apnea for patient education
Campbell, D. J., Estephan, L. E., Mastrolonardo, E. V., Amin, D. R., Huntley, C. T., & Boon, M. S. (2023) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10728 · Cited by 82
Yang, W., Cai, X., Hu, J., Wen, W., Heizhati, M., Yao, X., Yao, L., Zhu, Q., Hong, J., Luo, Q., et al. (2023) · Clinical Epidemiology · doi:10.2147/clep.s395938 · Cited by 81
Volpe, M., & Gallo, G. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1136340 · Cited by 87
Obstructive Sleep Apnea and Atrial Fibrillation
Moula, A. I., Parrini, I., Tetta, C., Lucà, F., Parise, G., Rao, C. M., Mauro, E., Parise, O., Matteucci, F., Gulizia, M. M., et al. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11051242 · Cited by 81
“A recent scientific statement from the American Heart Association (AHA) has confirmed this association [59].”
BackgroundNambiema, A., Lisan, Q., Vaucher, J., Perier, M., Boutouyrie, P., Danchin, N., Thomas, F., Guibout, C., Solelhac, G., Heinzer, R. C., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad657 · Cited by 70
“There are common mechanisms supporting the reported association between sleep patterns and CVD risk including increased BP, sympathetic activation, 51,52 chronic inflammation, 52 and oxidative stress.”
BackgroundCardiovascular Burden of Narcolepsy Disease (CV-BOND): a real-world evidence study
Ben-Joseph, R. H., Saad, R. S., Black, J. E., Dabrowski, E. C., Taylor, B., Gallucci, S., & Somers, V. K. (2023) · SLEEP · doi:10.1093/sleep/zsad161 · Cited by 66
“The resulting findings confirm and expand upon existing literature by demonstrating that the incidence rates of multiple cardiovascular events, including stroke, heart failure, ischemic stroke, MACE, grouped instances of stroke, atrial fibrillation, or edema, and CVD, were significantly higher in people with narcoleps…”
BackgroundInfluentialSelf-citationMandibular Advancement vs CPAP for Blood Pressure Reduction in Patients With Obstructive Sleep Apnea
Ou, Y.-H., Colpani, J. T., Cheong, C., Loke, W., Thant, A. T., Shih, E. C., Lee, F., Chan, S., Sia, C., Koo, C. Y., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.03.359 · Cited by 73
Ndumele, C. E., Rodriguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M., Bangalore, S., Bozkurt, B., Breathett, K., Clarke, S. L., et al. (2026) · JACC · doi:10.1016/j.jacc.2026.03.056 · Cited by 90
Self-citationEffects of Exercise on Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis
Peng, J., Yuan, Y., Zhao, Y., & Ren, H. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710845 · Cited by 55
“Continuous positive airway pressure (CPAP), the most common clinical treatment method, is effective in improving AHI and daytime sleepiness [15].”
BackgroundCamañes‐Gonzalvo, S., Bellot‐Arcís, C., Marco‐Pitarch, R., García‐Selva, M., Agustín‐Panadero, R., Paredes‐Gallardo, V., & Puertas, F. J. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101644 · Cited by 53
Puech, C., Badran, M., Runion, A. R., Barrow, M. B., Cataldo, K., & Gozal, D. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24129880 · Cited by 60
Thompson, C., Legault, J., Moullec, G., Baltzan, M., Cross, N. E., Dang‐Vu, T. T., Martineau‐Dussault, M., Hanly, P. J., Ayas, N., Lorrain, D., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-08164-6 · Cited by 62
Association between obstructive sleep apnea and cardiovascular diseases
Li, Y. E., & Ren, J. T. (2022) · Acta Biochimica et Biophysica Sinica · doi:10.3724/abbs.2022084 · Cited by 58
“OSA is characterized by partial obstruction of upper respiratory tract and reduced airflow or repetitive breathing cessation in sleep [3], resulting in unfavorable outcomes including sleep deprivation, intermittent hypoxemia (IH), intrathoracic pressure changes and surges in sympathetic tone [4].”
BackgroundGerman, C. A., Baum, S. J., Ferdinand, K. C., Gulati, M., Polonsky, T. S., Toth, P. P., & Shapiro, M. D. (2022) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2022.100432 · Cited by 55
Mechanisms of Atrial Fibrillation in Obstructive Sleep Apnoea
Saleeb-Mousa, J., Nathanael, D., Coney, A. M., Kalla, M., Brain, K. L., & Holmes, A. P. (2023) · Cells · doi:10.3390/cells12121661 · Cited by 55
“Key features of OSA include episodic exposure to hypoxia and hypercapnia, numerous microarousals, repetitive autonomic nervous system activation and large swings in intrathoracic pressure as the patient makes exaggerated respiratory efforts against an occluded upper airway [3].”
BackgroundChinese Guidelines for the Diagnosis and Treatment of Heart Failure 2024
ZHANG, S.-Y. (2025) · 老年心脏病学杂志:英文版 · doi:10.26599/1671-5411.2025.03.002 · Cited by 60
Ndumele, C. E., Rodríguez, F., Dixon, D. L., Khan, S. S., Mukherjee, D., Bajaj, M. S., Bangalore, S., Bozkurt, B., Breathett, K. K., Clarke, S. L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001453 · Cited by 101
Self-citationApproach the Patient With Obstructive Sleep Apnea and Obesity
Meyer, E. J., & Wittert, G. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad572 · Cited by 57
Belaïdi, E., Khouri, C., Harki, O., Baillieul, S., Faury, G., Briançon‐Marjollet, A., Pépin, J., & Arnaud, C. (2022) · European Respiratory Review · doi:10.1183/16000617.0269-2021 · Cited by 50
“OSA is recognised as an independent risk factor for incident and prevalent cardiovascular diseases, including hypertension, arrhythmia, stroke and coronary heart disease [2, 3].”
Mechanisms of Atrial Fibrillation: How Our Knowledge Affects Clinical Practice
Leventopoulos, G., Koros, R., Travlos, C. K., Perperis, A., Chronopoulos, P., Tsoni, E., Koufou, E., Papageorgiou, A., Apostolos, A., Kaouris, P., et al. (2023) · Life · doi:10.3390/life13061260 · Cited by 48
“The constellation of all these factors encourages arterial hypertension and increased left-atrial-wall stress, oxidative stress, and inflammation [53].”
BackgroundManiaci, A., Riela, P. M., Iannella, G., Lechien, J. R., Mantia, I. L., VINCENTIIS, M. D., Cammaroto, G., Calvo‐Henríquez, C., Luca, M. D., Chiesa-Estomba, C. M., et al. (2023) · Life · doi:10.3390/life13030702 · Cited by 49
“Obstructive sleep apnea (OSA) is a respiratory disorder characterized by the partial or total collapse of the upper airways with intermittent hypoxia, a chronic systemic inflammatory state, and an increased cardiovascular risk [1].”
BackgroundSleep and Stroke: Opening Our Eyes to Current Knowledge of a Key Relationship
Brunetti, V., Rollo, E., Broccolini, A., Frisullo, G., Scala, I., & Marca, G. D. (2022) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-022-01234-2 · Cited by 46
Chat GPT for the management of obstructive sleep apnea: do we have a polar star?
Mira, F. A., Favier, V., Nunes, H. D. S. S., de Castro, J. V., Carsuzaa, F., Meccariello, G., Vicini, C., Vito, A. D., Lechien, J. R., Chiesa-Estomba, C. M., et al. (2023) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-023-08270-9 · Cited by 44
“OSA has been linked to various complications, including hypertension, heart failure, coronary artery disease, cerebrovascular disease, metabolic syndrome, and type 2 diabetes [4].”
BackgroundHuang, H.-H., Stubbs, B., Chen, L., Ku, P., Hsu, T.-Y., Lin, C.-W., Weng, Y.-M., & Wu, S.-H. (2023) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-023-01449-7 · Cited by 47
Strumpf, Z. B., Gu, W., Tsai, C.-W., Chen, P., Yeh, E., Leung, L., Cheung, C., Wu, I.-C., Strohl, K. P., Tsai, T., et al. (2023) · Sleep Health · doi:10.1016/j.sleh.2023.05.001 · Cited by 47
Díaz‐García, E., Sánz-Rubio, D., García-Tovar, S., et al. (2022) · European Respiratory Journal · doi:10.1183/13993003.01401-2022 · Cited by 41
Li, Y., Miao, Y., & Zhang, Q. (2022) · SLEEP · doi:10.1093/sleep/zsac298 · Cited by 40
Association of adiposity with risk of obstructive sleep apnea: a population-based study
Deng, H., Duan, X., Huang, J., Zheng, M., Lao, M., Weng, F., Su, Q.-Y., Zheng, Z., Mei, Y., Huang, L., et al. (2023) · BMC Public Health · doi:10.1186/s12889-023-16695-4 · Cited by 43
“Therefore, participants with COPD or CVD were excluded to avoid potential bias.”
BackgroundInfluentialObstructive sleep apnea therapy for cardiovascular risk reduction—Time for a rethink?
Dissanayake, H. U., Colpani, J. T., Sutherland, K., Loke, W., Mohammadieh, A. M., Ou, Y.-H., de Chazal, P., Cistulli, P. A., & Lee, C. (2021) · Clinical Cardiology · doi:10.1002/clc.23747 · Cited by 40
“OSA (apnea-hypopnea index ≥15 events/h).(1,2) OSA is an important public health challenge due to its association with excessive daytime sleepiness, motor vehicle accidents, and various manifestations of metabolic, cardiovascular, and cerebrovascular diseases.”
BackgroundAging and atrial fibrillation: A vicious circle
Gao, P., Gao, X., Xie, B., Tse, G., & Liu, T. (2023) · International Journal of Cardiology · doi:10.1016/j.ijcard.2023.131445 · Cited by 40
The role of the GABAergic system on insomnia
Varinthra, P., Anwar, S. N. M. N., Shih, S.-C., & Liu, I. Y. (2024) · Tzu Chi Medical Journal · doi:10.4103/tcmj.tcmj_243_23 · Cited by 40
Papaetis, G. S. (2023) · Archives of Medical Science - Atherosclerotic Diseases · doi:10.5114/amsad/161170 · Cited by 41
“During this syndrome, the change in airway muscle tone that promotes their collapse (mainly during the inspiratory phase of breathing) cannot be compensated by increasing their activity to maintain airway patency [1, 2].”
InfluentialInsomnia Phenotypes, Cardiovascular Risk and Their Link to Brain Health
Fernández‐Mendoza, J. (2025) · Circulation Research · doi:10.1161/circresaha.125.325686 · Cited by 48
The Saturation Effect of Obesity on Bone Mineral Density for Older People: The NHANES 2017–2020
Zhang, Y. P., & Pu, J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.883862 · Cited by 37
Obstructive Sleep Apnea and Cardiovascular Disease: Where Do We Stand?
Peker, Y. (2023) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2023.3307 · Cited by 43
Sleep apnea is a common and dangerous cardiovascular risk factor
Henning, R. J., & Anderson, W. M. (2024) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2024.102838 · Cited by 41
Cistulli, P. A., Malhotra, A., Cole, K. V., Malik, A., Pépin, J., Kuniyoshi, F. H. S., Benjafield, A., Somers, V. K., Cistulli, P. A., Malhotra, A., et al. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.122.028733 · Cited by 37
Self-citationLu, M., Brenzinger, L., Rosenblum, L., Salanitro, M., Fietze, I., Glos, M., Fico, G., & Penzel, T. (2023) · Biomedical Engineering Letters · doi:10.1007/s13534-023-00304-9 · Cited by 39
“Untreated OSA is associated with an increased likelihood of comorbidities, such as hypertension, heart disease, and stroke [5, 6].”
BackgroundDelgado, L. M., Souza, V. D. S., Pompeu, B. F., Ogawa, T. D. M., Oliveira, H. P., Valladão, V. D. C. S., & Marques, F. A. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08044-8 · Cited by 39
“It is widely known that OSAS increases the risk of all-cause and cardiovascular mortality [35], and adequate blood pressure control in hypertensive patients is associated with improved survival rates [36].”
Obstructive Sleep Apnea, Obesity Hypoventilation Syndrome, and Pulmonary Hypertension
Bjork, S., Jain, D., Hache-Marliere, M., Predescu, S. A., & Mokhlesi, B. (2024) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2024.02.009 · Cited by 38
Recent Progress in Long-Term Sleep Monitoring Technology
Yin, J., Xu, J., & Ren, T. (2023) · Biosensors · doi:10.3390/bios13030395 · Cited by 36
“In contrast, there is a 40–80% prevalence among patients with cardiovascular disease [49].”
BackgroundIs obstructive sleep apnea a circadian rhythm disorder?
Šmon, J., Kočar, E., Pintar, T., Dolenc‐Grošelj, L., & Rozman, D. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13875 · Cited by 38
“Studies have connected undiagnosed obstructive sleep apnea to an increased likelihood of stroke (Yeghiazarians et al., 2021), work injuries (Chou et al., 2022), traffic accidents (Karimi et al., 2015), and functional impairment (Young et al., 2004).”
BackgroundShaik, L., Cheema, M. S., Subramanian, S., Kashyap, R., & Surani, S. (2022) · Medicina · doi:10.3390/medicina58121723 · Cited by 34
Patil, S. P., Billings, M. E., Bourjeily, G. R., Collop, N. A., Gottlieb, D. J., Johnson, K. G., Kimoff, R. J., & Pack, A. I. (2023) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10832 · Cited by 42
“Furthermore, SAVE excluded patients with moderate-severe sleepiness (ESS > 15), and while PREDICT included patients with ESS > 9, patients with a history of sleepiness while driving were specifically excluded.”
Ali, D., Qureshi, S., Siddiqui, H., Uddin, M. S., Waqas, S. A., Afridi, M. K., Sohail, M. U., Picker, S. M., Shahid, F., & Ahmed, R. (2025) · Heart & Lung · doi:10.1016/j.hrtlng.2025.01.005 · Cited by 35
Giblin, K., Kaplan, L. M., Somers, V. K., Le Roux, C. W., Hunter, D. J., Wu, Q., Lalonde, A., Ahmad, N., & Bethel, M. A. (2026) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.70209 · Cited by 34
Self-citationOSA diagnosis goes wearable: are the latest devices ready to shine?
Chiang, A. A.-P., Jerkins, E., Holfinger, S. J., Schutte-Rodin, S., Chandrakantan, A., Mong, L., Glinka, S., & Khosla, S. (2024) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11290 · Cited by 34
CPAP resumption after a first termination and impact on all-cause mortality in France
Pépin, J., Tamisier, R., Benjafield, A., Rinder, P., Lavergne, F., Josseran, A., Sinel-Boucher, P., Cistulli, P. A., Malhotra, A., Hornus, P., et al. (2023) · European Respiratory Journal · doi:10.1183/13993003.01171-2023 · Cited by 32
“OSA is characterised by recurrent complete or partial pharyngeal collapse during sleep, resulting in intermittent hypoxia, intrathoracic pressure swings and arousal from sleep [2, 3].”
BackgroundLiu, Z., Su, J., Zhou, K., Yu, B., Lin, Y., & Li, K. H. (2023) · Nano Letters · doi:10.1021/acs.nanolett.3c02071 · Cited by 33
Pennings, N. J., Golden, L., Yashi, K., Tondt, J., & Bays, H. E. (2022) · Obesity Pillars · doi:10.1016/j.obpill.2022.100043 · Cited by 35
Pau, M. C., Zinellu, A., Mangoni, A. A., Paliogiannis, P., Lacana, M. R., Fois, S. S., Mellino, S., Fois, A. G., Carru, C., Zinellu, E., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12123935 · Cited by 31
“Patients with OSA are known to have a high risk of developing ischemic heart disease, heart failure, arrhythmia, stroke, and transient ischemic attack [6,7].”
BackgroundThe impact of obstructive sleep apnea on nonalcoholic fatty liver disease
Tang, H., Lv, F., Zhang, P., Liu, J., & Mao, J. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1254459 · Cited by 37
“approximately 17%-34% of the middle-aged population meets the diagnostic criteria for OSA (3).”
Malhotra, A., Cole, K. V., Malik, A., Pépin, J., Kuniyoshi, F. H. S., Cistulli, P. A., Benjafield, A., Somers, V. K., Cistulli, P. A., Malhotra, A., et al. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.122.028732 · Cited by 32
Self-citationYang, R., Zhang, L., Guo, J., Wang, N., Zhang, Q., Qi, Z., Wu, L., Qin, L., & Liu, T. (2025) · Journal of Translational Medicine · doi:10.1186/s12967-025-06302-y · Cited by 35
Gut microbiota and derived metabolites mediate obstructive sleep apnea induced atherosclerosis
Xue, J., Allaband, C., Zuffa, S., Poulsen, O., Meadows, J. D., Zhou, D., Dorrestein, P. C., Knight, R. D., & Haddad, G. G. (2025) · Gut Microbes · doi:10.1080/19490976.2025.2474142 · Cited by 37
Senolytic-facilitated Reversal of End-Organ Dysfunction in a Murine Model of Obstructive Sleep Apnea
Badran, M., Puech, C., Khalyfa, A., Cortese, R., Cataldo, K., Qiao, Z., & Gozal, D. (2023) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202306-1101oc · Cited by 30
The role of ferroptosis in chronic intermittent hypoxia-induced lung injury
Chen, J., Zhu, H., Chen, Q., Yang, Y., Chen, M., Huang, J., Chen, M., & Lian, N. (2022) · BMC Pulmonary Medicine · doi:10.1186/s12890-022-02262-x · Cited by 30
Advances in basic and translational research in atrial fibrillation
Hu, D., Barajas-Martínez, H., Zhang, Z., Duan, H.-Y., Zhao, Q., Bao, M., Du, Y., Burashnikov, A., Monasky, M. M., Pappone, C., et al. (2023) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2022.0174 · Cited by 27
Luyster, F. S., Baniak, L. M., Imes, C. C., Jeon, B., Morris, J. L., Orbell, S. L., & Scott, P. W. (2024) · Sleep Health · doi:10.1016/j.sleh.2024.03.001 · Cited by 28
Non-Conventional Risk Factors: “Fact” or “Fake” in Cardiovascular Disease Prevention?
Cimmino, G., Natale, F., Alfieri, R., Cante, L. C., Covino, S., Franzese, R., Limatola, M., Marotta, L., Molinari, R., Mollo, N., et al. (2023) · Biomedicines · doi:10.3390/biomedicines11092353 · Cited by 34
“A diagnosis of OSA is made based on nocturnal breathing disorders (snoring, breathing pauses in sleep, restless sleep, awakening choking) and/or daytime sleepiness symptoms associated with an AHI >5; on the contrary, if the AHI index is greater than 15, OSA can be diagnosed in the absence of symptoms [139].”
BackgroundInfluentialChae, W. R., Baumert, J., Nübel, J., Brasanac, J., Gold, S. M., Hapke, U., & Otte, C. (2023) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2023.03.007 · Cited by 28
Sleep Irregularity, Circadian Disruption, and Cardiometabolic Disease Risk
Huang, T. (2025) · Circulation Research · doi:10.1161/circresaha.125.325613 · Cited by 39
Association of modifiable risk factors with obstructive sleep apnea: a Mendelian randomization study
Li, Y., Miao, Y., Tan, J., & Zhang, Q. (2023) · Aging · doi:10.18632/aging.205288 · Cited by 27
Xu, Y., Wang, J., Zhou, Z., Yang, Y., & Tang, L. (2023) · Archives of Medical Research · doi:10.1016/j.arcmed.2023.102926 · Cited by 27
Cardiovascular, kidney, and metabolic health: an actionable vision for heart failure prevention
Ostrominski, J. W., CHENG, A. Y. Y., Nelson, A. J., Neuen, B. L., Sattar, N. A., Tuttle, K. R., & Vaduganathan, M. (2025) · The Lancet · doi:10.1016/s0140-6736(25)01384-4 · Cited by 32
Müller, M. B., Stihl, C., Schmid, A., Hirschberger, S., Mitsigiorgi, R., Holzer, M., Patscheider, M., Weiss, B. G., Reichel, C. A., Hübner, M., et al. (2023) · Frontiers in Physiology · doi:10.3389/fphys.2023.1108966 · Cited by 30
“It is characterized by recurrent upper airway obstructions with associated hypoxic episodes ultimately promoting cardiovascular diseases such as atherosclerosis, myocardial infarction, and stroke (Yeghiazarians et al., 2021).”
BackgroundObstructive Sleep Apnea and Cardiac Arrhythmias: A Contemporary Review
Laczay, B., & Faulx, M. D. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10173785 · Cited by 32
“In patients with non-ischemic cardiomyopathies who have implanted cardiac defibrillators for the primary prevention of sudden death, OSA has been associated with an increased rate of inappropriate shocks [74].”
BackgroundObstructive Sleep Apnea–Induced Hypertension Is Associated With Increased Gut and Neuroinflammation
Ayyaswamy, S., Shi, H., Zhang, B., Bryan, R. M., & Durgan, D. J. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.122.029218 · Cited by 28
Prognostic Implications of OSA in Acute Coronary Syndrome by Obesity Status
Hao, W., Wang, X., Fan, J., Guo, R., Gong, W., Yan, Y., Zheng, W., Que, B., Ai, H., Ma, C., et al. (2023) · CHEST Journal · doi:10.1016/j.chest.2023.02.001 · Cited by 25
Puech, C., Badran, M., Runion, A. R., Barrow, M. B., Qiao, Z., Khalyfa, A., & Gozal, D. (2022) · Neurobiology of Sleep and Circadian Rhythms · doi:10.1016/j.nbscr.2022.100084 · Cited by 26
Adverse Cardiovascular Outcomes in Patients With Obstructive Sleep Apnea and Obesity
Aminian, A., Wang, L., Jabri, A., Wilson, R. L., Bena, J., Milinovich, A., Jin, J., Heinzinger, C. M., Peña-Orbea, C., Foldvary‐Schaefer, N., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.06.008 · Cited by 27
Self-citationZhou, Z., Zhao, Q., Huang, Y., Meng, S., Chen, X., Zhang, G., Chi, Y., Xu, D., Yin, Z., Jiang, H., et al. (2024) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.18407 · Cited by 24
Resistant hypertension: consensus document from the Korean society of hypertension
Park, S., Shin, J., Ihm, S., Kim, K., Kim, H., Kim, H. C., Lee, E. M., Lee, J. H., Ahn, S. Y., Cho, E. J., et al. (2023) · Clinical Hypertension · doi:10.1186/s40885-023-00255-4 · Cited by 26
Shi, Y., Ma, L., Chen, X., Li, W., Feng, Y., Zhang, Y., Cao, Z., Yuan, Y., Xie, Y., Liu, H., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.1042996 · Cited by 26
Rodríguez-Pérez, J., Andreu-Martínez, R., Daza, R., Fernández-Arroyo, L., Hernández-García, A., Díaz‐García, E., Cubillos‐Zapata, C., Lozano-Díez, A., Morales, A., Ramos, D., et al. (2025) · Antioxidants · doi:10.3390/antiox14070839 · Cited by 29
“This inflammatory state is known to induce or exacerbate cardiovascular and metabolic comorbidities such as type 2 diabetes mellitus, dyslipidemia, atherosclerosis, and ischemic heart disease [18,178–180].”
Beccuti, G., Bioletto, F., Parasiliti‐Caprino, M., Benso, A. S., Ghigo, E., Cicolin, A., & Broglio, F. (2024) · Current Obesity Reports · doi:10.1007/s13679-024-00592-x · Cited by 27
“The American Heart Association Scientific Statement on OSA and cardiovascular disease affirms that the risk of OSA correlates with BMI, and obesity remains the one major modifiable risk factor for OSA [3].”
BackgroundRole of sleep disorders in patients with cardiovascular disease: A systematic review
Zhang, L., Li, G., Bao, Y., & Liu, M. (2024) · International Journal of Cardiology Cardiovascular Risk and Prevention · doi:10.1016/j.ijcrp.2024.200257 · Cited by 27
“Moreover, approximately one billion adults (aged 30 – 69 years) are affected by obstructive sleep apnea (OSA), and half of these have moderate to severe OSA [3].”
BackgroundKasai, T., Kohno, T., Shimizu, W., Ando, S., Joho, S., Osada, N., Kato, M., Kario, K., Shiina, K., Tamura, A., et al. (2024) · Circulation Journal · doi:10.1253/circj.cj-23-0489 · Cited by 25
Lateral parabrachial FoxP2 neurons regulate respiratory responses to hypercapnia
Kaur, S., Lynch, N. A., Sela, Y., Lima, J. D., Thomas, R. C., Bandaru, S. S., & Saper, C. B. (2024) · Nature Communications · doi:10.1038/s41467-024-48773-5 · Cited by 24
Carra, M. C., Balagny, P., & Bouchard, P. (2024) · Periodontology 2000 · doi:10.1111/prd.12611 · Cited by 29
“56,186,187 be made (Figure 6B).”
Intermittent Hypoxia-Induced Cardiomyocyte Death Is Mediated by HIF-1 Dependent MAM Disruption
Moulin, S., Thomas, A., Wagner, S., Arzt, M. E., Dubouchaud, H., Lamarche, F., Bouyon, S., Vial, G., Godin‐Ribuot, D., Pépin, J., et al. (2022) · Antioxidants · doi:10.3390/antiox11081462 · Cited by 25
“, hypoxic burden, reoxygenation, duration) of the hypoxic pattern [63].”
Background
Metadata
- Authors
- Yeghiazarians, Y., Jneid, H., Tietjens, J. R., Redline, S., Brown, D. L., El-Sherif, N., Mehra, R., Bozkurt, B., Ndumele, C. E., Somers, V. K., & on behalf of the American Heart Association Council on Clinical Cardiology; Council on Peripheral Vascular Disease; Council on Arteriosclerosis, T. A. V. B. C. O. C.
- ORCID
- Venue
- Circulation
- Published
- 2021-07-20
- Volume
- 144
- Issue
- 3
- Pages
- e56-e67
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W3174072953
- Cited by
- 1,431
- References
- 52
- Citations by year
- 2026: 356 · 2025: 367 · 2024: 285 · 2023: 272 · 2022: 140 · 2021: 8
- FWCI
- 23.54
- Type
- journal article
- Language
- en
- Update notices
- correction (2022-03-21)
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology (medical) › Apelin-related biomedical research
- Keywords
- obstructive sleep apnea, cardiovascular disease, hypertension, heart failure, atrial fibrillation, pulmonary hypertension, stroke, intermittent hypoxemia, OSA screening, continuous positive airway pressure, oral appliances, weight loss, sleep-disordered breathing, nocturnal angina, sudden cardiac death, tachy-brady syndrome, ventricular tachycardia
- MeSH terms
- Animals, Cardiovascular Diseases, Disease Susceptibility, Humans, Mass Screening, Research, Risk Factors, Comorbidity, Risk Assessment, Disease Management, Sleep Apnea, Obstructive, Public Health Surveillance, Symptom Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review