Figure 5.

ANS Alterations in Cardiopulmonary-Related Sleep Disorders

Autonomic nervous system (ANS) function is influenced by sleep–wake (left) and circadian (right) rhythms. Obstructive sleep apnea (OSA) is influenced by the ANS (although to a variable degree according to specific endotype) and also alters ANS function. Autonomic dysfunction (AD) resulting from these factors influence cardiovascular function, including the time predilection for arrhythmias, diurnal blood pressure patterns, and cardiac events. Knowledge gaps (in circles) reflect the need for an improved understanding of the interactions of sleep, circadian and cardiovascular processes, and mediating roles of the ANS. Diagnostic, prognostic, mechanistic, and treatment needs follow these gaps. CVD = cardiovascular disease; NREM = non-rapid eye movement; PSG = polysomnography; REM = rapid eye movement; ROS = reactive oxygen species; SCD = sudden cardiac death; SDB = sleep disordered breathing.