Table of ContentsView AllTable of ContentsCardiac ArrestRespiratory ArrestType 1 DiabetesCarbon MonoxideMedicationsTraumaChokingEpilepsyOSASleep DisordersSummary
Table of ContentsView All
View All
Table of Contents
Cardiac Arrest
Respiratory Arrest
Type 1 Diabetes
Carbon Monoxide
Medications
Trauma
Choking
Epilepsy
OSA
Sleep Disorders
Summary
People die in their sleep due to various causes, with sudden cardiac arrest being one of the most common. Other reasons include conditions like congestive heart failure, stroke, orterminal illnessessuch as lung failure. Unexpected events, including seizures, drug overdoses, or carbon monoxide poisoning, may also lead to nocturnal death, sometimes without warning.
Certain underlying conditions, such as diabetes or obstructive sleep apnea (OSA), can increase the risk of dying in one’s sleep. Diabetes-related issues, like Dead in Bed Syndrome, may stem fromlow blood sugarduring the night, particularly in younger people with type 1 diabetes.OSA, on the other hand, can contribute to fatal events like heart attacks or strokes and, in rare cases, causeasphyxiation.
Oktay Ortakcioglu / StockPhoto
Cardiac arrest occurs when the heart suddenly stops beating. Without immediate medical treatment, sudden cardiac death will occur within minutes. The risk of death is higher during sleep simply because the emergency medical response is usually too late.
Of all of the possible causes of nocturnal death (death while sleeping), sudden cardiac arrest is among the most common. Of these, roughly 22% occur between the hours of 10:00 p.m. and 6:00 a.m., according to a 2021 study inHeart Rhythms.
There are several medical conditions that can lead to sudden cardiac arrest, includingheart attack,arrhythmia, congestive heart failure, and stroke.
How Quick Is Death From Heart Failure?Heart failure is not the same thing assudden cardiac death. With heart failure, in which the heart is less able to pump blood efficiently, death may come many years after the diagnosis.With cardiac arrest, in which the heart altogether stops, death can come in minutes.
How Quick Is Death From Heart Failure?
Heart failure is not the same thing assudden cardiac death. With heart failure, in which the heart is less able to pump blood efficiently, death may come many years after the diagnosis.With cardiac arrest, in which the heart altogether stops, death can come in minutes.
Heart Attack
Heart attacks, also known asmyocardial infarction, occur when a blood vessel supplying the heart muscle becomes obstructed and the tissue supplied is damaged or dies.
Myocardial infarctions may range from minor events that slightly compromise function to catastrophic blockages that lead to cardiac arrest and death.
Amassive heart attackcan reduce blood flow to the part of the brain that controls breathing, leading torespiratory arrest(the cessation of breathing).
Arrhythmias
The heart can also experience irregularities that impact its electrical system. The charge that is required to fire off the muscle in a synchronized fashion may become disrupted. The contractions may become irregular, too fast or too slow, and the heart’s pumping effectiveness may be compromised.
Arrhythmias may be a frequent cause of death during sleep.Asystoleis a cardiac arrest rhythm when the electrical activity of the heart cannot be detected.Atrial fibrillationor flutter may undermine cardiac function.
Similar ventricular rhythms, including ventriculartachycardia, may become fatal. Cardiac blocks affecting the electrical pattern may also lead to heart dysfunction and death.
Congestive Heart Failure
Congestive heart failure may also gradually lead to the failure of the heart and, in severe cases, cardiac arrest.
Left-sided heart failure quickly impacts the right side of the heart, leading to fluid accumulation in the lungs and swelling in the feet and legs calledperipheral edema. This can result in respiratory arrest.If the heart experiences volume overload, its ability to circulate blood may cease entirely.
Signs that a person with CHF is approaching the end of life include:
Stroke
The heart may affect other systems that rely on its ability to circulate blood. Most notably, an irregular heart rhythm may lead to a clot that travels to the brain and causes astroke. High blood pressure, or hypertension, may increase the risk.
If a stroke impacts the brainstem, breathing, eye-opening, muscle control, and consciousness may be compromised. These strokes may be fatal and can occur in sleep.
Is It Painful When You Die in Your Sleep?The experience of dying in your sleep varies depending on the cause. Some people die peacefully without feeling pain or becoming aware, while others wake up briefly and feel distress before dying. Certain conditions, like a heart attack or respiratory failure, may cause pain leading up to death.
Is It Painful When You Die in Your Sleep?
The experience of dying in your sleep varies depending on the cause. Some people die peacefully without feeling pain or becoming aware, while others wake up briefly and feel distress before dying. Certain conditions, like a heart attack or respiratory failure, may cause pain leading up to death.
At the most basic level, the lungs are responsible for the exchange of oxygen andcarbon dioxidewith the environment. When they do not function properly, oxygen levels fall, carbon dioxide levels rise, and dangerous changes in the acid-base balance of the body can occur.
When the imbalance is critical enough, respiratory arrest can occur. This can also place excessive strain on the heart and cause it to progressively fail.
Respiratory failure may occur due to chronic diseases that affect the lungs, airways, muscles, or nervous systems, such as:
There are even congenital disorders that affect the ability to breathe like congenital central hypoventilation syndrome.Sudden infant death syndrome(SIDS) represents a failure to breathe normally during sleep.
Diabetes can be an underlying cause of other illnesses, such as heart disease, that put you at risk for nocturnal death. It can cause night-time fluctuations in blood sugar that can result in unexpected death.
Even when they’re vigilant about managing their sugar levels during the day, people withtype 1 diabetescan face problems at night. Because you’re unable to monitor blood glucose during sleep, your levels may drop, causing seizures or death.
Carbon Monoxide Poisoning
If you’re sleeping, you won’t feel any of these effects, but as carbon monoxide enters the bloodstream, it prevents sufficient oxygen from circulating through the body’s organs. This leads to heart failure and respiratory arrest, which means that carbon monoxide can be fatal within minutes.
The drugs most likely to cause respiratory arrest when overused include:
Severe brain trauma can also cause sudden death, often while a person is sleeping. Sometimes symptoms like nausea, persistent headaches, and dilated pupils may go unrecognized or be dismissed following a head injury. In an effort to “sleep off” the symptoms, a person may experience abrain hemorrhage (bleed)during the night and die.
It is generally considered safe to sleep after a concussion, as long as you visit a healthcare provider or emergency room first for an evaluation. The provider may ask that you have someone wake you up every few hours as you sleep to ask a simple question, such as your name, then assess you for changes in how you look or act.
According to the Brain Trauma Foundation,traumatic brain injury (TBI)contributes to around 30% of all injury deaths in the United States.
It is also possible to choke to death while sleeping. This can occur if a person vomits during a nighttime seizure or after too much alcohol.
It can also happen if you fall asleep with food or a throat lozenge in your mouth and accidentally inhale it.
There is a condition known as sudden death in epilepsy (SUDEP) that is not fully understood. However, it affects 1 in 1,000 people withepilepsyeach year and is the leading cause of death in people with uncontrolled seizures.
Since SUDEP occurs frequently during the night, some researchers believe it is related to a person’s sleep-wake cycle.However, none of the reasons researchers have proposed have been definitively shown to cause death.
Obstructive Sleep Apnea
Obstructive sleep apnea(OSA) can exacerbate other medical conditions that may ultimately be fatal. These include strokes, heart attacks, heart failure, and arrhythmias that can all result in sudden death. Though unlikely, it is also possible for OSA to cause fatal asphyxiation, or choking.
Parasomnias
Parasomniasare a group of disruptive sleep disorders that cause abnormal movements, behaviors, and emotions during sleep. Although rare, these disorders can lead to fatal situations if the sleeping person unknowingly engages in dangerous activities, like walking into traffic or injuring themselves during episodes.
Parasomnias that can have fatal outcomes include:
Parasomnias affect both children and adults. Fortunately, there are several treatment options and safety measures, like locking windows and removing sharp objects from the bed area, that can effectively prevent dangerous outcomes.
The idea that you could die suddenly in your sleep is frightening. It is, however, rare to die in your sleep without having been diagnosed with a terminal condition. You might have risk factors, though, that increase the possibility of nocturnal death.
If you have heart disease or type 1 diabetes, talk to your healthcare provider about taking extra precautions to defend against dying in your sleep. Check your home for carbon monoxide leaks and talk to your healthcare provider about medications. Also, be sure to discuss any sleep disorders that could increase the possibility of accidents or asphyxiation while you sleep.
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jones J, James S, Brown F, O’Neal D, Ekinci E.Dead in bed - a systematic review of overnight deaths in type I diabetes.DRCP. 2022 Sep;191(1):110042. doi:10.1016/j.diabres.2022.110042Ramireddy A, Chugh HS, Reinier K.Sudden cardiac death during nighttime hours.Heart Rhythm.2021 May;18(5):778–84. doi:10.1016/j.hrthm.2020.12.035American Heart Association.Advanced heart failure.American Heart Association.About cardiac arrest.Metkus T, Albaeni A, Chandra-Strobos N, Eid S.Incidence and prognostic impact of respiratory support in patients with ST-segment elevation myocardial infarction.Am J Cardiol. 2016 Oct;119(2):171-177. doi:10.1016/j.amjcard.2016.09.037Samuel M, Elsokkari I, Sapp J.Ventricular tachycardia burden and mortality: Association or causality?.Canadian J Cardiol. 2022 Apr;38(4):454-464. doi:10.1016/j.cjca.2022.01.016Mansukhani MP, Wang S, Somers VK.Sleep, death, and the heart.Am J Physiol Heart Circ Physiol.2015;309(5):H739-49. doi:10.1152/ajpheart.00285.2015Mass General Brigham.End-stage heart failure.UC Health.Brainstem stroke.National Heart, Lung, and Blood Institute.Causes and risk factors.Moon RY.SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.Pediatrics. 2016;138(5). doi:10.1542/peds.2016-2940Gagnum V, Stene LC, Jenssen TG, et al.Causes of death in childhood-onset Type 1 diabetes: long-term follow-up.Diabet Med. 2017;34(1):56-63. doi:10.1111/dme.13114O’Reilly J, Blackbourn L, Caparrotta T, et al.Time trends in deaths before age 50 years in people with type 1 diabetes: A nationwide analysis from Scotland 2004-2017.Diabetologia. 2020 May;63(8):1626–1636. doi:10.1007/s00125-020-05173-wCenters for Disease Control and Prevention.Carbon monoxide poisoning.Kripke DF.Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit.F1000Res. 2016;5:918. doi:10.12688/f1000research.8729.3Mount Sinai.Concussion - what to ask your doctor - adult.Brain Trauma Foundation.Frequently asked questions.National Institute on Alcohol Abuse and Alcoholism.Understanding the dangers of alcohol overdose.Dlouhy BJ, Gehlbach BK, Richerson GB.Sudden unexpected death in epilepsy: basic mechanisms and clinical implications for prevention.J Neurol Neurosurg Psychiatry. 2016;87(4):402-413. doi:10.1136/jnnp-2013-307442Joyal KG, Kreitlow BL, Buchanan GF.The role of sleep state and time of day in modulating breathing in epilepsy: implications for sudden unexpected death in epilepsy.Front Neural Circuits. 2022;16:983211. doi:10.3389/fncir.2022.983211Heilbrunn E, Ssentongo P, Chinchill V, Oh J, Ssentongo A.Sudden death in individuals with obstructive sleep apnoea: A systematic review and meta-analysis.BMJ Open Resp Res. 2021 Jun;8(1):e000656. doi:10.1136/bmjresp-2020-000656Singh S, Kaur H, Singh S, Khawaja I.Parasomnias: A comprehensive review.Cureus. 2018 Dec;10(12):e3807. doi:10.7759/cureus.3807Additional ReadingHublin C,et al.Sleep and mortality: a population-based 22-year follow-up study.Sleep. 2007 Oct;30(10):1245-53.Jeyaraj D,et al.Circadian rhythms govern cardiac repolarization and arrhythmogenesis.Nature.2012. doi:10.1038/nature10852Kryger MH,et al.Principles and Practice of Sleep Medicine.Elsevier, 6th edition, 2016.Shepard JJ.Hypertension, cardiac arrhythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea.Clin Chest Med1992;13:437-458.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jones J, James S, Brown F, O’Neal D, Ekinci E.Dead in bed - a systematic review of overnight deaths in type I diabetes.DRCP. 2022 Sep;191(1):110042. doi:10.1016/j.diabres.2022.110042Ramireddy A, Chugh HS, Reinier K.Sudden cardiac death during nighttime hours.Heart Rhythm.2021 May;18(5):778–84. doi:10.1016/j.hrthm.2020.12.035American Heart Association.Advanced heart failure.American Heart Association.About cardiac arrest.Metkus T, Albaeni A, Chandra-Strobos N, Eid S.Incidence and prognostic impact of respiratory support in patients with ST-segment elevation myocardial infarction.Am J Cardiol. 2016 Oct;119(2):171-177. doi:10.1016/j.amjcard.2016.09.037Samuel M, Elsokkari I, Sapp J.Ventricular tachycardia burden and mortality: Association or causality?.Canadian J Cardiol. 2022 Apr;38(4):454-464. doi:10.1016/j.cjca.2022.01.016Mansukhani MP, Wang S, Somers VK.Sleep, death, and the heart.Am J Physiol Heart Circ Physiol.2015;309(5):H739-49. doi:10.1152/ajpheart.00285.2015Mass General Brigham.End-stage heart failure.UC Health.Brainstem stroke.National Heart, Lung, and Blood Institute.Causes and risk factors.Moon RY.SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.Pediatrics. 2016;138(5). doi:10.1542/peds.2016-2940Gagnum V, Stene LC, Jenssen TG, et al.Causes of death in childhood-onset Type 1 diabetes: long-term follow-up.Diabet Med. 2017;34(1):56-63. doi:10.1111/dme.13114O’Reilly J, Blackbourn L, Caparrotta T, et al.Time trends in deaths before age 50 years in people with type 1 diabetes: A nationwide analysis from Scotland 2004-2017.Diabetologia. 2020 May;63(8):1626–1636. doi:10.1007/s00125-020-05173-wCenters for Disease Control and Prevention.Carbon monoxide poisoning.Kripke DF.Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit.F1000Res. 2016;5:918. doi:10.12688/f1000research.8729.3Mount Sinai.Concussion - what to ask your doctor - adult.Brain Trauma Foundation.Frequently asked questions.National Institute on Alcohol Abuse and Alcoholism.Understanding the dangers of alcohol overdose.Dlouhy BJ, Gehlbach BK, Richerson GB.Sudden unexpected death in epilepsy: basic mechanisms and clinical implications for prevention.J Neurol Neurosurg Psychiatry. 2016;87(4):402-413. doi:10.1136/jnnp-2013-307442Joyal KG, Kreitlow BL, Buchanan GF.The role of sleep state and time of day in modulating breathing in epilepsy: implications for sudden unexpected death in epilepsy.Front Neural Circuits. 2022;16:983211. doi:10.3389/fncir.2022.983211Heilbrunn E, Ssentongo P, Chinchill V, Oh J, Ssentongo A.Sudden death in individuals with obstructive sleep apnoea: A systematic review and meta-analysis.BMJ Open Resp Res. 2021 Jun;8(1):e000656. doi:10.1136/bmjresp-2020-000656Singh S, Kaur H, Singh S, Khawaja I.Parasomnias: A comprehensive review.Cureus. 2018 Dec;10(12):e3807. doi:10.7759/cureus.3807Additional ReadingHublin C,et al.Sleep and mortality: a population-based 22-year follow-up study.Sleep. 2007 Oct;30(10):1245-53.Jeyaraj D,et al.Circadian rhythms govern cardiac repolarization and arrhythmogenesis.Nature.2012. doi:10.1038/nature10852Kryger MH,et al.Principles and Practice of Sleep Medicine.Elsevier, 6th edition, 2016.Shepard JJ.Hypertension, cardiac arrhythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea.Clin Chest Med1992;13:437-458.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Jones J, James S, Brown F, O’Neal D, Ekinci E.Dead in bed - a systematic review of overnight deaths in type I diabetes.DRCP. 2022 Sep;191(1):110042. doi:10.1016/j.diabres.2022.110042Ramireddy A, Chugh HS, Reinier K.Sudden cardiac death during nighttime hours.Heart Rhythm.2021 May;18(5):778–84. doi:10.1016/j.hrthm.2020.12.035American Heart Association.Advanced heart failure.American Heart Association.About cardiac arrest.Metkus T, Albaeni A, Chandra-Strobos N, Eid S.Incidence and prognostic impact of respiratory support in patients with ST-segment elevation myocardial infarction.Am J Cardiol. 2016 Oct;119(2):171-177. doi:10.1016/j.amjcard.2016.09.037Samuel M, Elsokkari I, Sapp J.Ventricular tachycardia burden and mortality: Association or causality?.Canadian J Cardiol. 2022 Apr;38(4):454-464. doi:10.1016/j.cjca.2022.01.016Mansukhani MP, Wang S, Somers VK.Sleep, death, and the heart.Am J Physiol Heart Circ Physiol.2015;309(5):H739-49. doi:10.1152/ajpheart.00285.2015Mass General Brigham.End-stage heart failure.UC Health.Brainstem stroke.National Heart, Lung, and Blood Institute.Causes and risk factors.Moon RY.SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.Pediatrics. 2016;138(5). doi:10.1542/peds.2016-2940Gagnum V, Stene LC, Jenssen TG, et al.Causes of death in childhood-onset Type 1 diabetes: long-term follow-up.Diabet Med. 2017;34(1):56-63. doi:10.1111/dme.13114O’Reilly J, Blackbourn L, Caparrotta T, et al.Time trends in deaths before age 50 years in people with type 1 diabetes: A nationwide analysis from Scotland 2004-2017.Diabetologia. 2020 May;63(8):1626–1636. doi:10.1007/s00125-020-05173-wCenters for Disease Control and Prevention.Carbon monoxide poisoning.Kripke DF.Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit.F1000Res. 2016;5:918. doi:10.12688/f1000research.8729.3Mount Sinai.Concussion - what to ask your doctor - adult.Brain Trauma Foundation.Frequently asked questions.National Institute on Alcohol Abuse and Alcoholism.Understanding the dangers of alcohol overdose.Dlouhy BJ, Gehlbach BK, Richerson GB.Sudden unexpected death in epilepsy: basic mechanisms and clinical implications for prevention.J Neurol Neurosurg Psychiatry. 2016;87(4):402-413. doi:10.1136/jnnp-2013-307442Joyal KG, Kreitlow BL, Buchanan GF.The role of sleep state and time of day in modulating breathing in epilepsy: implications for sudden unexpected death in epilepsy.Front Neural Circuits. 2022;16:983211. doi:10.3389/fncir.2022.983211Heilbrunn E, Ssentongo P, Chinchill V, Oh J, Ssentongo A.Sudden death in individuals with obstructive sleep apnoea: A systematic review and meta-analysis.BMJ Open Resp Res. 2021 Jun;8(1):e000656. doi:10.1136/bmjresp-2020-000656Singh S, Kaur H, Singh S, Khawaja I.Parasomnias: A comprehensive review.Cureus. 2018 Dec;10(12):e3807. doi:10.7759/cureus.3807
Jones J, James S, Brown F, O’Neal D, Ekinci E.Dead in bed - a systematic review of overnight deaths in type I diabetes.DRCP. 2022 Sep;191(1):110042. doi:10.1016/j.diabres.2022.110042
Ramireddy A, Chugh HS, Reinier K.Sudden cardiac death during nighttime hours.Heart Rhythm.2021 May;18(5):778–84. doi:10.1016/j.hrthm.2020.12.035
American Heart Association.Advanced heart failure.
American Heart Association.About cardiac arrest.
Metkus T, Albaeni A, Chandra-Strobos N, Eid S.Incidence and prognostic impact of respiratory support in patients with ST-segment elevation myocardial infarction.Am J Cardiol. 2016 Oct;119(2):171-177. doi:10.1016/j.amjcard.2016.09.037
Samuel M, Elsokkari I, Sapp J.Ventricular tachycardia burden and mortality: Association or causality?.Canadian J Cardiol. 2022 Apr;38(4):454-464. doi:10.1016/j.cjca.2022.01.016
Mansukhani MP, Wang S, Somers VK.Sleep, death, and the heart.Am J Physiol Heart Circ Physiol.2015;309(5):H739-49. doi:10.1152/ajpheart.00285.2015
Mass General Brigham.End-stage heart failure.
UC Health.Brainstem stroke.
National Heart, Lung, and Blood Institute.Causes and risk factors.
Moon RY.SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment.Pediatrics. 2016;138(5). doi:10.1542/peds.2016-2940
Gagnum V, Stene LC, Jenssen TG, et al.Causes of death in childhood-onset Type 1 diabetes: long-term follow-up.Diabet Med. 2017;34(1):56-63. doi:10.1111/dme.13114
O’Reilly J, Blackbourn L, Caparrotta T, et al.Time trends in deaths before age 50 years in people with type 1 diabetes: A nationwide analysis from Scotland 2004-2017.Diabetologia. 2020 May;63(8):1626–1636. doi:10.1007/s00125-020-05173-w
Centers for Disease Control and Prevention.Carbon monoxide poisoning.
Kripke DF.Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit.F1000Res. 2016;5:918. doi:10.12688/f1000research.8729.3
Mount Sinai.Concussion - what to ask your doctor - adult.
Brain Trauma Foundation.Frequently asked questions.
National Institute on Alcohol Abuse and Alcoholism.Understanding the dangers of alcohol overdose.
Dlouhy BJ, Gehlbach BK, Richerson GB.Sudden unexpected death in epilepsy: basic mechanisms and clinical implications for prevention.J Neurol Neurosurg Psychiatry. 2016;87(4):402-413. doi:10.1136/jnnp-2013-307442
Joyal KG, Kreitlow BL, Buchanan GF.The role of sleep state and time of day in modulating breathing in epilepsy: implications for sudden unexpected death in epilepsy.Front Neural Circuits. 2022;16:983211. doi:10.3389/fncir.2022.983211
Heilbrunn E, Ssentongo P, Chinchill V, Oh J, Ssentongo A.Sudden death in individuals with obstructive sleep apnoea: A systematic review and meta-analysis.BMJ Open Resp Res. 2021 Jun;8(1):e000656. doi:10.1136/bmjresp-2020-000656
Singh S, Kaur H, Singh S, Khawaja I.Parasomnias: A comprehensive review.Cureus. 2018 Dec;10(12):e3807. doi:10.7759/cureus.3807
Hublin C,et al.Sleep and mortality: a population-based 22-year follow-up study.Sleep. 2007 Oct;30(10):1245-53.Jeyaraj D,et al.Circadian rhythms govern cardiac repolarization and arrhythmogenesis.Nature.2012. doi:10.1038/nature10852Kryger MH,et al.Principles and Practice of Sleep Medicine.Elsevier, 6th edition, 2016.Shepard JJ.Hypertension, cardiac arrhythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea.Clin Chest Med1992;13:437-458.
Hublin C,et al.Sleep and mortality: a population-based 22-year follow-up study.Sleep. 2007 Oct;30(10):1245-53.
Jeyaraj D,et al.Circadian rhythms govern cardiac repolarization and arrhythmogenesis.Nature.2012. doi:10.1038/nature10852
Kryger MH,et al.Principles and Practice of Sleep Medicine.Elsevier, 6th edition, 2016.
Shepard JJ.Hypertension, cardiac arrhythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea.Clin Chest Med1992;13:437-458.
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