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
Items 401–500 of 1,407
Sun, J.-W., Hsu, H.-C., Wu, J.-J., Huang, T., Tsai, Y.-S., Cheng, W.-H., & Lin, L. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106768 · Cited by 6
Kim, D.-H., Han, J. Y., Jung, H., Song, D., Lee, C., Ryu, G., Hong, S. D., Kim, H. Y., & Jung, Y. G. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s540460 · Cited by 8
“6 Considering the growing number of diagnosed OSA patients, high rates of underdiagnosis, and increased risk of cardiovascular and metabolic complications associated with OSA, 7 prompt and accurate diagnosis is important.”
InfluentialYan, L., Zhang, L., Zhai, L., Wang, L., Deng, S., Hao, X., Zhang, Y., & Gao, X. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1669661 · Cited by 7
Inflammation in Obstructive Sleep Apnea: A Global Bibliometric Perspective
Fan, H., Niu, H., Zhao, B., & Gao, X. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s554362 · Cited by 6
Artificial intelligence in imaging for obstructive sleep apnea: A comprehensive review
Zhang, X., Xiong, Z., Zhou, Y., & Zeng, X. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108662 · Cited by 6
Rogowski, A., Szafarowski, T., Chotkowska, E., Sienkiewicz‐Jarosz, H., Wichniak, A., Szafarowska, M., Baranowski, W., Kukwa, W., Maksym, R., Samochowiec, J., et al. (2026) · International Urogynecology Journal · doi:10.1007/s00192-026-06553-3 · Cited by 6
“In particular, OSA may cause frequent awakenings leading to sleep fragmentation and a deficiency of deep sleep [2].”
2026 ESC Guidelines on cardiac rehabilitation
Bäck, M., Wilhelm, M., Marcin, T., Machado, F. V. C., Sandberg, A., Buccheri, S., Conde, A. C., Czapla, M., Rosa, S. D., Gibson, I., et al. (2026) · European Heart Journal · doi:10.1093/eurheartj/ehag099 · Cited by 27
Li, N., Zhang, Y., Yang, F., Zhang, H., Yu, X., Lu, K., Wang, J., Ma, H., & Ni, X. (2022) · Sleep And Breathing · doi:10.1007/s11325-022-02711-1 · Cited by 6
“The clinical symptoms and complications of OSAS have a serious impact on quality of life and health [2, 3].”
BackgroundZheng, P., Chalidapongse, P., & Changsiripun, C. (2023) · Sleep And Breathing · doi:10.1007/s11325-023-02796-2 · Cited by 6
“…condition characterized by frequent episodes of complete or partial upper airway collapse during sleep, and is associated with excessive daytime sleepiness, neurocognitive dysfunction, impaired quality of life, and higher risks of cardiovascular and cerebrovascular morbidity and mortality [1–3].”
BackgroundMashaqi, S., RIHAWI, A., Rangan, P., Ho, K. L., Khokhar, M., Helmick, S., Ashouri, Y., Combs, D., Ghaderi, I., & Parthasarathy, S. (2023) · Frontiers in Sleep · doi:10.3389/frsle.2023.1212936 · Cited by 6
Arslan, R. S. (2023) · PeerJ Computer Science · doi:10.7717/peerj-cs.1554 · Cited by 7
Body mass index, neck circumference, and hypertension: a prospective cohort study
Ren, T.-J., Zhang, K., Li, W., et al. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1269328 · Cited by 6
Time for bed: diet, sleep and obesity in children and adults
Miller, M. A. (2023) · Proceedings of The Nutrition Society · doi:10.1017/s0029665123004846 · Cited by 6
Taherifard, E., Taherifard, E., Hosseini‐Bensenjan, M., Sayadi, M., & Haghpanah, S. (2023) · Hemoglobin · doi:10.1080/03630269.2023.2290507 · Cited by 7
Huang, J., Zhang, H., Cao, L., Chen, F., Lin, W., Lu, Q., Huang, X., Weng, Q., & Yang, Q. Z. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1320954 · Cited by 6
Dai, L., Guo, J., Hui, X., Wang, X., Luo, J., Huang, R., & Xiao, Y. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.01.010 · Cited by 5
A risk prediction nomogram for resistant hypertension in patients with obstructive sleep apnea
Lin, H., Zhou, C., Li, J., Ma, X., Yang, Y., & Zhu, T. (2024) · Scientific Reports · doi:10.1038/s41598-024-56629-7 · Cited by 8
“OSA is quite common in patients with heart disease and interact with heart disease to lead to unfavorable cardiovascular events 31 .”
BackgroundFujita, Y., Yamauchi, M., & Muro, S. (2024) · Respiratory Investigation · doi:10.1016/j.resinv.2024.05.004 · Cited by 7
Wan, J., Wang, P., Liu, S., Wang, X., Zhou, P., & Yang, J. (2024) · Journal of Clinical Hypertension · doi:10.1111/jch.14863 · Cited by 5
Song, J., Xu, S., Chen, Q., Gou, Y., Zhao, C., Jia, C., Liu, H., Zhang, Z., Li, B., Gao, Y., et al. (2024) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.18543 · Cited by 5
On, S.-W., Kim, D., Lee, M. H., Lee, J. H., Lee, K. C., Byun, S., & Hong, S. J. (2024) · Clinical and Experimental Otorhinolaryngology · doi:10.21053/ceo.2024.00124 · Cited by 7
Carra, M. C., & Cistulli, P. A. (2024) · Australian Dental Journal · doi:10.1111/adj.13040 · Cited by 6
Fessler, L., Tessitore, E., Craviari, C., Sarrazin, P. G., Meyer, P., Luthy, C., Hanna-Deschamps, E., & Cheval, B. (2024) · BMC Sports Science Medicine and Rehabilitation · doi:10.1186/s13102-024-00997-0 · Cited by 7
“Finally, although this study focused on PA and SB, other important lifestyle factors, such as diet and sleep, play a significant role in the management and outcomes of cardiovascular disease [78–80].”
MethodChange in Sleep Quality Associated With Adaptive Servoventilation for Central Sleep Apnea
Tamisier, R., Philippe, C., Prigent, A., d’Ortho, M., d'ORTHO, M.-P., Gagnadoux, F., Launois, C., Launois, C., Mallet, J., Mallet, J. P., et al. (2024) · CHEST Journal · doi:10.1016/j.chest.2024.12.015 · Cited by 6
Wang, L., Wang, Y., Jiao, T., Xu, L., Ji, E., Tapu, S. R., Liu, Y., & Li, J. (2025) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-024-03252-2 · Cited by 7
Leibovitz, S., Levi, S., Hanut, A., Yanko, R., Sharav, Y., & Haviv, Y. (2025) · Sleep And Breathing · doi:10.1007/s11325-025-03249-8 · Cited by 6
“Positive associations between OSA and increased risks of cardiovascular diseases [4], Hypertension [ 5 ], neurological disorders and dementia [6], stroke [ 7 ], metabolic disorder [8], cancer [9] and other conditions have been found.”
Inter-rater reliability of video clips to assess for obstructive sleep apnea in children
Katz, S. L., Blinder, H., Dussah, N., et al. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106483 · Cited by 6
Krüger, M., Obst, A., Bernhardt, O., Ewert, R., Penzel, T., Stubbe, B., Fietze, I., Ivanovska, T., Biffar, R., & Daboul, A. (2022) · Sleep And Breathing · doi:10.1007/s11325-022-02614-1 · Cited by 7
“The disorder received increasing attention in the past decade, largely because of the growing research linking OSAS to cardiovascular disease [1] and to a decline in neurocognitive [2] and behavioral functions [3].”
BackgroundSu, Y., Li, C., Liu, W., Liu, Y., Li, L., & Chen, Q. (2022) · Frontiers in Genetics · doi:10.3389/fgene.2022.918728 · Cited by 6
“The prevalence of OSA is about 17% and 34% in middle-aged women and men, respectively (Yeghiazarians et al., 2021).”
BackgroundSleep quality, sleep apnea, and metabolic health in children treated with adenotonsillectomy
Magnúsdóttir, S., Witmans, M., & Hilmisson, H. (2022) · Sleep And Breathing · doi:10.1007/s11325-022-02747-3 · Cited by 7
Jin, S., Ding, X., Guo, D., Qin, Y., Zhu, W., Zhao, Z., Guo, X., Li, Y., Lu, X., & Cai, Q. (2022) · BMC Cardiovascular Disorders · doi:10.1186/s12872-022-03006-9 · Cited by 6
“Background Obstructive sleep apnea syndrome (OSAS), which is characterized by recurrent reduction or cessation of breathing during sleep, has aroused extensive attention due to its high prevalence [1] and proven association with many cardiovascular diseases, such as atrial fibrillation, Xiuzhang Lu and Qizhe Cai have…”
BackgroundChețan, I. M., Hancu, B. D., Beyer, R. S., Tomoaia, R., Cabău, G., Vulturar, D.-M., Chiș, A. F., Leșan, A., Vesa, Ș. C., Pop, D., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-26940-2 · Cited by 6
Juang, C., Pan, G.-R., Huang, W., Wen, C.-Y., & Wu, M. (2022) · IEEE Transactions on Fuzzy Systems · doi:10.1109/tfuzz.2022.3222033 · Cited by 6
“This shows that there is a very high proportion of people, such as those with hypertension or kidney disease have potential comorbidities with OSAHS [2], [5].”
BackgroundMacek, P., Michałek-Zrąbkowska, M., Dziadkowiec-Macek, B., Poręba, M., Martynowicz, H., Mazur, G. J., Gać, P., & Poręba, R. (2023) · Life · doi:10.3390/life13030671 · Cited by 6
“Notably, 40–80% of patients with hypertension, heart failure, atrial fibrillation, and ischemic heart disease suffer from OSA [11].”
BackgroundSawunyavisuth, B., Sopapol, N., Tseng, C., & Sawanyawisuth, K. (2023) · Future Science OA · doi:10.2144/fsoa-2022-0073 · Cited by 8
Olszowka, M., Hagström, E., Hadziosmanovic, N., Ljunggren, M. E., Denchev, S. V., Manolis, A. J., Wallentin, L. C., White, H. D., Stewart, R., & Held, C. (2023) · International Journal of Cardiology · doi:10.1016/j.ijcard.2023.131395 · Cited by 6
“[4 ] Furthermore, differences in the associations between individual SRBD-related symptoms and CV disease suggest the coexistence of several underlying pathophysiological mechanisms and phenotypes causing adverse prognosis in individuals with concomitant frequent SRBD-related symptoms and…”
A clinical review of obstructive sleep apnea
Sisson, C. G. B. (2023) · JAAPA · doi:10.1097/01.jaa.0000977668.78287.0c · Cited by 6
Keenan, B. T., Magalang, U. J., & Maislin, G. (2024) · SLEEP · doi:10.1093/sleep/zsae064 · Cited by 6
Impact of obstructive sleep apnea on prognosis of patients with cardiometabolic multimorbidity
Liu, X., Li, S., Wang, X., Fan, J., Gong, W., Yan, Y., Ai, H., Que, B., Zheng, W., & Nie, S. (2024) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-024-01403-y · Cited by 7
Hellemans, S., de Perck, E. V., Loo, D. V., Verbraecken, J. A., Sands, S. A., Azarbarzin, A., Dieltjens, M., de Beeck, S. O., Vroegop, A. V. M. T., & Vanderveken, O. M. (2024) · Life · doi:10.3390/life14080963 · Cited by 6
“If left untreated, OSA has been associated with adverse cardiovascular, metabolic, neurocognitive and behavioral sequelae [1–3].”
BackgroundGiordano, N. A., Houser, M. C., Pelkmans, J. L., Pasquel, F. J., Pak, V., Rogers, A. E., Yeager, K. A., Mucha, S., Schmitt, M. G., & Miller, A. H. (2024) · Nursing Research · doi:10.1097/nnr.0000000000000779 · Cited by 7
“Fatigue is a commonly reported symptom among individuals with both OSA and hypertension; however, screening efforts for OSA often focus on sleepiness, which in turn can hinder accurate diagnosis of OSA in certain populations with both hypertension and OSA (Yeghiazarians et al., 2021).”
Gender-specific associations between sleep stages and cardiovascular risk factors
Taporoski, T. P., Beijamini, F., Alexandria, S. J., Aaby, D., Krieger, J. E., von Schantz, M., Pereira, A. C., & Knutson, K. L. (2024) · SLEEP · doi:10.1093/sleep/zsae242 · Cited by 6
Identification and Validation of Prognostic Factors of Lipid Metabolism in Obstructive Sleep Apnea
Peng, L., Wang, X., & Bing, D. (2021) · Frontiers in Genetics · doi:10.3389/fgene.2021.747576 · Cited by 6
Patoulias, D., Dimosiari, A., Michailidis, T., Roditis, P., & Lampropoulos, S. (2022) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2022.06.022 · Cited by 6
Brown, R. B. (2022) · Diseases · doi:10.3390/diseases10040089 · Cited by 7
“Furthermore, a scientific statement from the American Heart Association notes that obstructive sleep apnea (OSA), “episodic cycles of breathing disruption”, increases risk of “all-cause mortality and cardiovascular mortality”, and is “often underrecognized and undertreated in cardiovascular practice” [18].”
BackgroundGiarratano, Y., Hill, E. A., Hamid, C., Wiseman, S. J., Gray, C. D., Chappell, F. M., Coello, R. D., Valdés-Hernández, M. C., Ballerini, L., Stringer, M. S., et al. (2024) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x241291958 · Cited by 5
Controversies in hypertension therapy: bedtime dosing or daytime dosing?
Li, H., Sun, R., Li, Y., Yue, X., Ni, L., Zhou, L., & Zhao, C. (2025) · Journal of Hypertension · doi:10.1097/hjh.0000000000004035 · Cited by 6
“OSA, a significant contributor to secondary hypertension [55], is disrupted nocturnal BP patterns, often characterized by a nondipper pattern in patients with OSA [56–60].”
Saad, R. S., Lillaney, P. V., Profant, D. A., Fuller, D. S., Poole, E. M., Alvord, T., Prince, P., Desai, S., Whalen, M., Ni, W., et al. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106587 · Cited by 5
Huang, X., Hu, W., Chen, L., Ma, L., Yu, G., Chen, J., Zhang, H., Cao, F., & Wang, H. (2025) · Clinical and Experimental Hypertension · doi:10.1080/10641963.2025.2511056 · Cited by 5
“This cascade may lead to endothelial cell injury and dysfunction, resulting in atherosclerosis, vascular inflammation, endothelial remodeling, and increased vascular resistance, ultimately causing hypertension (14).”
Riney, H., Thorndike, F. P., Ágústsson, J. S., Helgason, S., Hauser, K., Baran, A. S., Kauss, T., Salinas, G. D., Edington, S., & Wickwire, E. M. (2025) · Frontiers in Sleep · doi:10.3389/frsle.2025.1593874 · Cited by 5
Zhang, X., Wang, D., & Liu, J. (2025) · PLoS ONE · doi:10.1371/journal.pone.0326499 · Cited by 5
“The prevalence of sleep apnea among cardiovascular diseases patients is as high as 40% to 80%, and the prognosis for these patients is poorer [17,18].”
Zhang, Y., Li, T., & Yu, H. (2025) · Scientific Reports · doi:10.1038/s41598-025-11246-w · Cited by 6
“As a result, identifying reliable IR markers is crucial for timely diagnosis and the implementation of preventive measures to reduce CVD incidence and mortality.”
InfluentialNatale, A., & Mohanty, S. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf460 · Cited by 5
Tan, L., Li, T., Zhang, X., et al. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf648 · Cited by 5
Deep Neural Network Algorithm Using the Electrocardiogram for Detection of Obstructive Sleep Apnea
Covassin, N., Liu, K., Bukartyk, J., Timm, P. C., Friedman, P. A., Louis, E. K. S., Attia, Z. I., & Somers, V. K. (2025) · JACC Advances · doi:10.1016/j.jacadv.2025.102139 · Cited by 9
Self-citationEndocrinology and the Lung: Exploring the Bidirectional Axis and Future Directions
Iglesias, P. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14196985 · Cited by 10
“Although CPAP improves cardiovascular and some hormonal parameters, its impact on glycemic control and metabolic syndrome remains limited [142].”
Sleep Apnea: The Slept-Upon Cardiovascular Risk Factor
Pintilie, A.-L., Marcu, D. T. M., Antal, A. Z., Arcana, R. I., Iosep, D. G., Miron, M., Afloarei, C. A., Zabara, M., & Crișan-Dabija, R. A. (2025) · Biomedicines · doi:10.3390/biomedicines13102529 · Cited by 7
“OSA’s prevalence is recorded at as high as 40–80% among patients with hypertension, heart failure, coronary artery disease, pulmonary hypertension, atrial fibrillation, and stroke [5].”
Sun, Q., Xu, Y., Tan, W., Yao, Z., Ruan, H., Yang, Y., Duan, S., & Wang, J. (2025) · International Journal of Cardiology · doi:10.1016/j.ijcard.2025.133993 · Cited by 5
Badran, M., Puech, C., & Gozal, D. (2025) · npj Aging · doi:10.1038/s41514-025-00283-4 · Cited by 5
López-Monzoni, S., Pumarega, I. C., Puech, C., Mediano, O., & Sánchez‐de‐la‐Torre, M. (2025) · Therapeutic Advances in Respiratory Disease · doi:10.1177/17534666251384397 · Cited by 6
“5 OSA is a significant independent risk factor for various CV outcomes, including hypertension, arrhythmia, coronary heart disease, heart failure, stroke, and sudden death.”
Müller, M. B., Kammerer, T., Khan, H., Schmid, A., Hirschberger, S., Hübner, M., Barth, T. K., Mitsigiorgi, R., Stihl, C., Holzer, M., et al. (2026) · Journal of Translational Medicine · doi:10.1186/s12967-026-08409-2 · Cited by 6
“OSA-associated intermittent hypoxia promotes endothelial inflammation and oxidative stress and reduces nitric oxide bioavailability, thereby impairing endothelial homeostasis [12, 13, 16].”
Martinot, J., Lê-Dông, N.-N., Borel, A., Tamisier, R., Malhotra, A., & Pépin, J. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15169 · Cited by 6
“5,6 13-16 Key intermediary mechanisms underlying the association between OSA, and type 2 diabetes include intermittent hypoxia (hypoxic burden) and sleep fragmentation leading to oxidative stress, low-grade inflammation and sympathetic overactivity.”
BackgroundDesai, R., Mellacheruvu, S. P., Akella, S. A., Mohammed, A. S., Saketha, P., Mohammed, A. A., Hussain, M., Bavanasi, A., Gummadi, J., & Sunkara, P. (2023) · Medical Sciences · doi:10.3390/medsci11040069 · Cited by 5
Zeng, L., Shu, Y., Xie, W., Zeng, Y., Li, K., Long, T., Huang, L., Liu, X., Li, H., & Peng, D. (2024) · Nature and Science of Sleep · doi:10.2147/nss.s442253 · Cited by 5
Ogbu, I. R., Hakobyan, B., Sossou, C. W., Levisman, J. M., Obiagwu, C., & Danielian, A. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-073991 · Cited by 5
Yan, Z., Xu, Y., Li, K., & Liu, L. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e32514 · Cited by 5
“Given the close association between OSA and cardiovascular mortality risk [2], this study also specifically explored the association between FI and cardiovascular mortality risk in OSA patients.”
BackgroundJuhl, C. B., Bladbjerg, E., Gram, B., Knudsen, T., Lauridsen, M. M., Nygaard, N.-P. B., Drøjdahl, N., Skadhauge, L. R., & Münster, A. B. (2024) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s456028 · Cited by 7
“20 This could be caused by the fact that the symptoms, in part, occur during sleep and that daytime symptoms, such as the tendency to fall asleep or tiredness during daytime, are considered normal occurrences.”
BackgroundAdvances in non-coding RNA as a biomarker for obstructive sleep apnoea hypoventilation syndrome
Li, J., Sun, L., & Zhao, Y. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03109-x · Cited by 5
“They are also often associated with cardiovascular disease [7], Alz-heimer's disease(AD) [8], Parkinson's disease [9], or tumors [10].”
Nag, D. S., Koshy, V., Swain, A., Patel, R., Sahu, S., & Sam, M. (2024) · World Journal of Clinical Cases · doi:10.12998/wjcc.v12.i35.6754 · Cited by 5
Gabryelska, A., Turkiewicz, S., Gajewski, A., Jaromirska, J., Strzelecki, D., Białasiewicz, P., Chałubiński, M., & Sochal, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-88834-3 · Cited by 5
Li, B., Yang, H., Lv, X., Guo, X., Xu, F., & Li, X. (2025) · International Journal of Cardiology Cardiovascular Risk and Prevention · doi:10.1016/j.ijcrp.2025.200455 · Cited by 5
“The presence of OSAS is a significant concern for arrhythmic conditions, with 58 % of OSAS patients being afflicted by some form of arrhythmia, among which sinus tachycardia or bradycardia are the most common [16].”
Esmaeili, N., Aritake, S., Redline, S. S., Winkelman, J. W., & Azarbarzin, A. (2025) · SLEEP · doi:10.1093/sleep/zsaf310 · Cited by 5
Self-citationValidation Study of Airgo, an Innovative Device to Screen Sleep Respiratory Disorders
Braghiroli, A., Kuller, D., Godio, M., Rossato, F., Sacco, C., & Morrone, E. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.938542 · Cited by 6
Dong, L., Wu, G., Chi, W., Zhang, J., Qiao, T., Zhang, J., & Song, D. (2022) · Annals of Palliative Medicine · doi:10.21037/apm-22-975 · Cited by 4
Çetin-Atalay, R., Meliton, A. Y., Sun, K. A., Glass, M., Woods, P. S., Peng, Y., Fang, Y. H., Hamanaka, R. B., Prabhakar, N. R., & Mutlu, G. M. (2022) · Scientific Reports · doi:10.1038/s41598-022-21614-5 · Cited by 6
Obstructive sleep apnea, myocardial perfusion and myocardial blood flow: A study of older male twins
Vaccarino, V., Shah, A. J., Moncayo, V. M., Nye, J. A., Piccinelli, M., Ko, Y., Ma, X., Murrah, N. V., Shallenberger, L. H., Driggers, E. G., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0278420 · Cited by 5
Ho, J. T. F., Zhou, N., & de Lange, J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm12010311 · Cited by 7
Mahmoud, M. I., Alotaibi, R., Almusally, R. M., Shafiek, H., Elamin, Y., Alhaj, Z., Albaker, W. I., Elfaki, A., Qutub, H. O., Albahrani, S. J., et al. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1020617 · Cited by 5
Luzzi, V., Altieri, F., Guaragna, M., et al. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043255 · Cited by 5
“In addition, OSAS can cause cardiovascular and cerebrovascular damage [14].”
BackgroundWhat is the Best Antihypertensive Treatment for OSA?
Lima-Junior, J. G. A., Martins, A. V. V., & Drager, L. F. (2023) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2023.03.006 · Cited by 5
Qi, P., Qi, B., Ding, Y., Sun, J., Gu, C., Huo, S., Liu, Y., & Zhao, B. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.05.013 · Cited by 6
Liu, S., Cao, K. N., Garner, A. M., Punjabi, N. M., & Pietzsch, J. B. (2023) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462323000272 · Cited by 6
“International Journal of Technology Assessment in Health Care, 39(1), e32, 1–10 https://doi.”
InfluentialHuang, Z., Duan, A., Zhao, Z., Zhao, Q., Zhang, Y., Li, X., Zhang, S., Gao, L., An, C., Luo, Q., et al. (2023) · Nature and Science of Sleep · doi:10.2147/nss.s423221 · Cited by 5
Urinary metabolite signatures reflect the altered host metabolism in severe obstructive sleep apnea
Mohit, M., Tomar, M. S., Araniti, F., Sahai, P., Singh, B. P., Shrivastava, A., & Chand, P. (2023) · Journal of Chromatography B · doi:10.1016/j.jchromb.2023.123938 · Cited by 5
Armario, P., Avellaneda-Gómez, C., & Gómez-Choco, M. J. (2023) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2023.11.014 · Cited by 5
Xu, S., Hao, L.-L., Liu, F., & Xu, C. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03005-4 · Cited by 5
Li, T., Rong, L., Gao, Y. L., & Cheng, W. (2024) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2024.1406192 · Cited by 5
Non-cardiac comorbidities in heart failure: an update on diagnostic and management strategies
Kodur, N., & Tang, W. H. W. (2024) · Minerva Medica · doi:10.23736/s0026-4806.24.09070-0 · Cited by 6
Signal detection of drugs associated with obstructive and central sleep apnoea
Jambon-Barbara, C., Revol, B., Hlavaty, A., Joyeux‐Faure, M., Borel, J., Cracowski, J., Pépin, J., & Khouri, C. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.09.045 · Cited by 5
Zhong, Y., Wang, B., Huang, J., Nian, M.-X., Zhao, J., & Chen, G. (2024) · Nature and Science of Sleep · doi:10.2147/nss.s480186 · Cited by 5
“25 Additionally, REM-AHI is linked to the development of metabolic syndrome, affecting insulin sensitivity and glucose metabolism, thereby increasing the risk of diabetes 26 Regarding the nervous system, the absence of REM sleep is correlated with cognitive decline and emotional disorders.”
Diagnostic performance of a doppler radar-based sleep apnoea testing device
Röcken, J., Darie, A. M., Grize, L., Dexter, C. E., Herrmann, M. J., Jahn, K., Strobel, W. M., Tamm, M., & Stolz, D. (2025) · BMC Pulmonary Medicine · doi:10.1186/s12890-025-03618-9 · Cited by 5
“In contrast to mild OSA, (moderate to) severe OSA has been shown to be a significant cardiovascular risk factor for patients [22, 23].”
Yang, P., Huang, Y., He, W., Chen, T., Wei, S., & Zhao, Y. (2025) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s541688 · Cited by 5
“34 OSA is linked to skin disease both epidemiologically and mechanistically.”
Diagnosis of Obstructive Sleep Apnea in Patients with Associated Comorbidity
del Campo, F., Domingo, C. A. A., Zamarrón, C., & Álvarez, D. (2022) · Advances in experimental medicine and biology · doi:10.1007/978-3-031-06413-5_4 · Cited by 5
Sleep-disordered breathing and heart failure: a vicious cycle of cardiovascular risk
Cacciapuoti, F., D’Onofrio, A., Tarquinio, L. G., Capone, V., Mauro, C., Marfella, R., & Cacciapuoti, F. (2023) · Monaldi Archives for Chest Disease · doi:10.4081/monaldi.2023.2660 · Cited by 6
“Sleep apnea and heart failure share similar clinical manifestations, such as paroxysmal nocturnal dyspnea, fluid retention, and fatigue, and they also have overlapping neuro-hormonal characteristics, including reduced availability of nitric oxide and increased inflammatory indices.”
BackgroundZaki, I., Phyu, S. L., & Turnbull, C. D. (2023) · Medicine · doi:10.1016/j.mpmed.2023.08.004 · Cited by 5
Zhao, L., Zhao, Y., Su, D., Lv, Z. P., Xie, F., Hu, P., Porter, K., Mazzei, I., Chin, J. D., Wang, Y., et al. (2023) · Brain Sciences · doi:10.3390/brainsci13101436 · Cited by 5
Parenti, S. I., Cesari, C., Godenza, V. D., Zanarini, M., Zangari, F., & Bonetti, G. A. (2025) · Applied Sciences · doi:10.3390/app15020542 · Cited by 5
He, Q., Zhou, Y., Tong, X., Zhen, L., Shi, S., Gong, W., & Nie, S. (2025) · Journal of Inflammation Research · doi:10.2147/jir.s515437 · Cited by 4
Zhao, L., Zhang, W. Y., Gao, Y., Cai, W.-M., Zhao, Z., Rui, D., Zhang, Z., Lin, J., Li, F., Ma, C., et al. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06281-1 · Cited by 4
“A scientific statement from the American Heart Association says that about 34% and 17% of middle-aged men and women have OSAS [5].”
The Role of Mitochondria in Obstructive Sleep Apnea: Implications for the Upper Airway Muscles
Carlos, K., do Prado, G. F., & Tengan, C. H. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262110562 · Cited by 5
“%) among individuals with cardiovascular disease [15].”
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