Chinese Consensus Report on the Assessment and Management of Obstructive Sleep Apnea in Patients with Cardiovascular Disease: 2024 Edition

As cardiovascular disease (CVD) incidence and mortality rates continue to rise in China, the importance of identifying and managing CVD risk factors grows. Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder, affecting an estimated 936 million individuals aged 30-69 worldwide, with China leading globally with about 176 million affected. Increasing research indicates a close association between OSA and the onset and progression of various CVD, significantly affecting outcomes. However, OSA has long been underrecognized and undertreated in CVD clinical practice. To address this gap, a multidisciplinary expert panel developed evidence-based recommendations using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology and the Delphi process. This consensus provides 17 recommendations on core clinical issues such as screening, diagnosis, treatment, and follow-up of CVD patients with OSA, aiming to standardize care and improve patient outcomes. The recommendations were informed by current evidence-based research and extensive expert consensus discussions. This approach seeks to support clinical decision-making, improve the quality of care, and address the unique challenges of managing OSA in Chinese CVD patients. •This report provides 17 evidence-based recommendations to improve OSA screening, diagnosis, treatment, and follow-up in CVD management.•CPAP is identified as the primary treatment for OSA in CVD patients, emphasizing individualized and multidisciplinary approaches.•The STOP-Bang questionnaire is recommended for OSA risk assessment, with PSG as the diagnostic gold standard and portable monitoring as an alternative.•The consensus highlights the importance of weight management, positional therapy, and advancements in oral appliances, surgery, and emerging pharmacotherapies.•Novel measures such as hypoxic burden and loop gain are proposed to refine OSA severity assessment, addressing limitations of traditional AHI metrics.