BACKGROUND: Obstructive sleep apnea (OSA) is one of the main risk factors for cardiovascular diseases and is associated with both morbidity and mortality. OSA has also been linked to arrhythmias and sudden death.
OBJECTIVE: To assess whether OSA increases the risk of sudden death in the non-cardiac population.
METHODS: This is a systematic review of the literature. The descriptors \"sudden death\" and \"sleep apnea\" and \"tachyarrhythmias\" and \"sleep apnea\" were searched in the PubMed/Medline and SciELO databases.
RESULTS: Thirteen articles that addressed the relationship between OSA and the development of tachyarrhythmias and/or sudden death with prevalence data, electrocardiographic findings, and a relationship with other comorbidities were selected. The airway obstruction observed in OSA triggers several systemic repercussions, e.g., changes in intrathoracic pressure, intermittent hypoxia, activation of the sympathetic nervous system and chemoreceptors, and release of catecholamines. These mechanisms would be implicated in the appearance of arrhythmogenic factors, which could result in sudden death.
CONCLUSIONS: There was a cause-effect relationship between OSA and cardiac arrhythmias. In view of the pathophysiology of OSA and its arrhythmogenic role, studies have shown a higher risk of sudden death in individuals who previously had heart disease. On the other hand, there is little evidence about the occurrence of sudden death in individuals with OSA and no heart disease, and OSA is not a risk factor for sudden death in this population.

BACKGROUND: The treatment of obstructive sleep apnea with positive airway pressure in children is restricted due to concerns that it could affect maxilla growth over time.
OBJECTIVE: To undertake a systematic review of the literature about the long-term impact of using a positive airway pressure mask on the midface in growing individuals.
METHODS: The literature search was conducted in September 2019 using the keywords (\"long-term\" OR \"long term\" OR \"side effects\" OR longitudinal) AND (children OR child OR preschool OR adolescents OR adolescent OR infant OR infants) AND (craniofacial OR \"mid-face\" OR midface OR midfacial OR facial OR maxillary) AND (\"airway pressure\" OR ventilation) in the databases PubMed, Web of Science and Lilacs. The search included papers published in English, until September 2019, on the effects of positive airway pressure on midfacial growth.
RESULTS: The search strategy identified five studies: two case reports, two cross-sectional studies and one retrospective cohort study. All studies evaluated the long-term effects of a using a nasal mask on the midface in children and adolescents; four showed midface hypoplasia and one no showed difference post- treatment compared to a control.
CONCLUSIONS: Most of the studies demonstrated that long-term use of nasal positive airway pressure in childhood/adolescence is associated with midface hypoplasia.