Sleep‐disordered breathing in valvular heart disease: A Modifiable comorbidity

Abstract Sleep‐disordered breathing (SDB) is highly prevalent among patients with valvular heart disease (VHD) and is independently associated with adverse clinical outcomes. The two major phenotypes—obstructive sleep apnea (OSA) and central sleep apnea (CSA)—exhibit distinct distributions across VHD subtypes. CSA predominates in severe aortic stenosis, combined rheumatic lesions, and mitral regurgitation with reduced ejection fraction, reflecting advanced hemodynamic compromise, whereas OSA is more common in isolated mitral stenosis and decompensated heart failure. CSA severity closely correlates with cardiac dysfunction, whereas OSA independently predicts perioperative complications. Valve surgery and transcatheter interventions substantially improve CSA but exert limited effects on OSA. Notably, our research team has devoted over a decade to this field and generated several important findings. This review concisely summarizes the epidemiology, clinical characteristics, pathophysiological mechanisms, and particularly the bidirectional interactions between SDB and VHD, aiming to provide evidence‐based guidance for optimizing clinical management strategies.