Cardiac Autonomic Dysfunction in Obstructive Sleep Apnea : The Hidden Role of Vitamin D Deficiency

Huai Heng, Loh and Siow Phing, Tay and Ai Jiun, Koa and Mei Ching, Yong and Asri, Said and Chee Shee, Chai and Natasya Marliana, Abdul Malik and Anselm, Su Ting and Bonnie Bao Chee, Tang and Florence Hui Sieng, Tan and Norlela, Sukor (2025) Cardiac Autonomic Dysfunction in Obstructive Sleep Apnea : The Hidden Role of Vitamin D Deficiency. Journal of Evidence-Based Medicine. pp. 1-4. ISSN 1756-5391

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Abstract

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder, affecting an estimated 9–38% of adults worldwide, with prevalence increasing in parallel with rising obesity rates and aging population [1]. While men are still more likely to be diagnosed with OSA, this condition is becoming more common in women [2]. Coronary artery disease (CAD), a common complication of OSA, is driven by a combination of intermittent hypoxia, metabolic dysfunction, and systemic inflammation, which together accelerate atherosclerosis [3]. This underscores the importance of identifying modifiable factors to mitigate cardiovascular risks in these patients. A key mechanism linking OSA to heightened cardiovascular risks in CAD is cardiac autonomic dysfunction, characterized by increased sympathetic activity and reduced parasympathetic tone. These alterations can be assessed through heart rate variability (HRV), a well-established predictor of adverse cardiovascular outcomes.

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