Hi, as you a said, there is sleep apnea
, and dyspnoea on exertion. They strongly suggest heart problem, may be valular defects. I advise you to consult a cardiologist
for diagnosis and treatment . You may need to have echo cardiogram, for confirmation of the condition. Other causes may be the anemia
, cardiac involveing hypo thyroidism, etc. arthritis
may be due secondary to the cardiac problem, or indipendent. Thank you.