Findings from a recent study
show that patients with untreated, moderate to severe obstructive sleep
apnea had a higher risk of experiencing a cardiovascular event, but the
risk of incident heart problems was decreased in those who used CPAP
Results show that people with moderate to severe sleep apnea and no
record of CPAP use were 71% more likely than those without sleep apnea
to experience incident myocardial infarction, stroke, unstable angina,
heart failure or cardiovascular death. Compared with the risk of heart
problems in people with untreated sleep apnea, the risk of experiencing a
cardiovascular event was 32% lower in patients with any severity of
sleep apnea who used CPAP therapy, and it was 44% lower in those with
moderate to severe sleep apnea who used CPAP.
"Our study contributes to understanding the role of CPAP therapy for
cardiovascular risk prevention," said lead author Diego R Mazzotti,
who has a doctorate in psychobiology and is an assistant professor in
the division of medical informatics in the department of internal
medicine at the University of Kansas Medical Center. "We found the
effects of CPAP were stronger in patients with moderate to severe sleep
apnea, as well as in patients who used CPAP, on average, greater than 4
hours per night."
The researchers analyzed the electronic health records of patients
who received a sleep study between January 2018 and September 2020
through the Kaiser Permanente Southern California health system. The
sample comprised 11,145 people without sleep apnea, 13,898 patients with
sleep apnea and a record of any CPAP use, and 20,884 patients with
sleep apnea and no record of CPAP use. To be eligible for the analysis,
patients had to be free of cardiovascular disease for one year prior to
their sleep apnea diagnosis. Results were adjusted for baseline age,
sex, body mass index, race/ethnicity, comorbidities, and use of
anti-hypertensives and lipid-lowering medications. The median follow-up
period was 262 days.
"Our study, while observational, suggests that clinical trials
focused on understanding how to sustain long-term CPAP adherence in
obstructive sleep apnea patients are necessary and could be critical for
optimizing comorbidity risk reduction," said Mazzotti.
Nearly 30 million adults in the U.S. have obstructive sleep apnea, a chronic disease that involves the repeated collapse of the upper airway during sleep. Common warning signs include snoring and excessive daytime sleepiness. A common treatment is CPAP therapy, which uses mild levels of air pressure, provided through a mask, to keep the throat open during sleep.
The study is a multi-site collaboration between Kaiser Permanente
Southern California (led by Dr. Jiaxiao Shi, lead regional research
statistician, and Dr. Dennis Hwang, medical director of sleep medicine)
and the University of Pennsylvania School of Nursing (led by Dr. Amy
Sawyer, associate professor of sleep & health behavior).
The research abstract was published recently in an online supplement of the journal Sleep and will be presented as a poster beginning June 9 during Virtual SLEEP 2021.
SLEEP is the annual meeting of the Associated Professional Sleep
Societies, a joint venture of the American Academy of Sleep Medicine and
the Sleep Research Society.
Source: News Release
American Academy of Sleep Medicine
June 9, 2021