What question did this study set out to answer?

This review aims to analyze the prevalence and clinical impact of sleep disordered breathing in patients with aortic stenosis.

January 10, 2026Sleep Medicine Research0 citationsOpen Access

Sleep Disordered-Breathing and Aortic Valve Stenosis: A Systematic Review and Meta-Analysis

HRHeba Ramadan

Key Result

The pooled prevalence of sleep-disordered breathing in aortic stenosis patients was 76%, indicating a significant association between the two conditions.

Key Points

This review aims to analyze the prevalence and clinical impact of sleep disordered breathing in patients with aortic stenosis.
Systematic search of multiple databases following PRISMA guidelines.
Inclusion of observational studies detailing both conditions in adults.
Data extraction focused on prevalence, diagnostic methods, and outcomes.
Quality assessment using JBI and Newcastle-Ottawa tools.
Meta-analyses conducted with odds ratios and prevalence estimates.
76% pooled prevalence of sleep disordered breathing in aortic stenosis patients.
Equal prevalence of obstructive sleep apnea (49%) and central sleep apnea (51%).
Higher prevalence of sleep disordered breathing found in males (OR=1.68).
Body mass index was generally higher in obstructive sleep apnea cases.
Sleep disordered breathing associated with increased odds of aortic stenosis (OR=1.16).

Structured PICO

Population

Adults with aortic stenosis (AS) and sleep-disordered breathing (SDB), comprising 11 observational studies (9 prevalence-focused, 2 comparative).

Intervention

Sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA) and central sleep apnea (CSA)

Comparator

Patients without sleep-disordered breathing (SDB) or patients without aortic stenosis (AS)

Outcome

Prevalence of SDB in AS patients and odds of AS in patients with SDB

Sleep-disordered breathing is highly prevalent (76%) in patients with aortic stenosis, and patients with SDB have significantly higher odds of having AS, suggesting a potential bidirectional association.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background and Objective Sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA) and central sleep apnea (CSA), is common in older adults and linked to cardiovascular disease. Aortic stenosis (AS), is another prevalent condition in this population. The interaction between SDB and AS remains unclear, particularly regarding outcomes after surgical aortic valve replacement or transcatheter aortic valve implantation. This review systematically examines the prevalence, clinical impact, and potential bidirectional relationship between SDB and AS.Methods Following PRISMA guidelines, multiple databases were searched. Eligible observational studies included adults with both AS and SDB, reporting prevalence or comparative outcomes. Data extraction included study characteristics, diagnostic methods, interventions, and prevalence estimates. Quality assessment employed JBI and Newcastle-Ottawa tools. Metaanalyses were performed using odds ratios (OR), standardized mean differences, and prevalence estimates with random or fixed effects models based on heterogeneity.Results A total of 11 studies met inclusion criteria (9 prevalence-focused, 2 comparative). Pooled prevalence of SDB in AS patients was 76% (95% confidence interval CI: 63%–89%). Both OSA (49%) and CSA (51%) were observed. Male sex was more common among patients with SDB (OR=1.68, 95% CI: 1.07–2.62). Body mass index (BMI) tended to be higher in OSA than CSA, though not consistently significant. In comparative analyses, patients with SDB showed higher odds of AS (OR=1.16, 95% CI: 1.14–1.17).Conclusions SDB is highly prevalent in AS and may contribute to disease progression. Findings suggest a possible bidirectional association influenced by sex and BMI. Larger wellmatched cohorts with long-term follow-up before and after valve interventions are needed to clarify causality and treatment effects.

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