The high prevalence of obstructive sleep apnea (OSA) and its worrisome association with various cardiovascular diseases, particularly ischemic heart disease, demand our attention. This common sleep disordered breathing, characterized by partial or complete upper airway obstructions during sleep, profoundly impacts overall health.^, In the cardiovascular context, intermittent hypoxia, sleep fragmentation, and intrathoracic pressure swings promoted by repeated respiratory events during sleep promote several potentially deleterious phenomena, including increased sympathetic activity, blood pressure fluctuations, chronic systemic inflammation, reactive oxygen species production, and endothelial dysfunction.^– These factors create a fertile ground for the development and progression of atherosclerosis,^, significantly increasing the likelihood of ischemic events if the condition remains undetected and untreated.^, However, the relationship between OSA and acute myocardial infarction (AMI) is complex. Patients with OSA often share risk factors that also increase AMI risk, notably age, male sex, and obesity. While some evidence suggests an independent role for OSA in the cardiovascular risk, its contribution remains controversial in high-risk patients with multiple comorbidities. Further research in this area is therefore warranted in order to provide additional insights.

In this issue of the International Journal of Cardiovascular Sciences, Carrijo et al. explore the complex relationship between OSA and traditional risk factors in 145 patients with ST-segment elevation myocardial infarction (STEMI). The authors used employed the widely used STOP-BANG questionnaire to assess OSA risk. The initial results were consistent with previous literature: a high frequency (58.6%) of patients exhibited a high risk for OSA. This highlights the urgent need for increased attention to this comorbidity, particularly in this specific patient population. In the multivariate analysis, the authors found an independent association of OSA with both male sex and hypertension in these patients. The presence of hypertension in OSA patients is not coincidental. Some of the aforementioned mechanisms associated with OSA directly contribute to elevated blood pressure, thereby increasing cardiovascular risk.^,

[…]

OBJECTIVE: To evaluate the influence of the siesta in ambulatory blood pressure (BP) monitoring and in cardiac structure parameters. METHODS: 1940 ambulatory arterial blood pressure monitoring tests were analyzed (Spacelabs 90207, 15/15 minutes from 7:00 to 22:00 hours and 20/20 minutes from 22:01 to 6.59hours) and 21% of the records indicated that the person had taken a siesta (263 woman, 52±14 years). The average duration of the siesta was 118±58 minutes. RESULTS: (average ± standard deviation) The average of systolic/diastolic pressures during wakefulness, including the napping period, was less than the average for the period not including the siesta (138±16/85±11 vs 139±16/86±11 mmHg, p<0.05); 2) pressure loads during wakefulness including the siesta, were less than those observed without the siesta); 3) the averages of nocturnal sleep blood pressures were similar to those of the siesta, 4) nocturnal sleep pressure drops were similar to those in the siesta including wakefulness with and without the siesta; 5) the averages of BP in men were higher (p5%. CONCLUSION: The siesta influenced the heart structure parameters and from a statistical point of view the average of systolic and diastolic pressures and the respective pressure loads of the wakeful period.