Management of acute cardiovascular consequences of sleep disorders: clinical implications for improved patient outcomes

INTRODUCTION: Sleep disorders such as insomnia, restless legs syndrome (RLS) and sleep disordered breathing such as obstructive sleep apnea (OSA) and central sleep apnea (CSA) are increasingly recognized as independent risk factors for acute cardiovascular events. AREAS COVERED: This review highlights the key mechanisms linking sleep disorders to acute cardiovascular events, including autonomic dysregulation, intermittent hypoxia, systemic inflammation, and endothelial dysfunction. These contribute to arrhythmias, acute coronary syndromes, heart failure exacerbations, and strokes. OSA stands out due to its strong association with cardiovascular risk through repetitive hypoxia and sympathetic activation. Treatment options like CPAP, ASV, and phrenic nerve stimulation show benefits, though long-term cardiovascular outcomes are still being studied. Despite growing evidence, sleep disorders remain underdiagnosed in cardiac patients, underscoring the need for improved screening and management. EXPERT OPINION: Integrating sleep evaluations into routine cardiovascular care could help reduce acute events and improve outcomes. Increased screening, better awareness among clinicians, and accessible treatment pathways are essential. Further longitudinal research is needed to confirm causal links and assess the sustained cardiovascular benefits of managing sleep disorders, especially in high-risk groups.