CPAP Use Reduces Incidence Of Cardiovascular Events And Hypertension In OSA Patients

(Medical News Today) In non-sleepy patients withobstructive sleep apnea (OSA), treatment with continuous positive airway pressure (CPAP) can reduce the incidence of cardiovascular events and hypertension, according to researchers from Spain. 

The research will be presented at the ATS 2010 International Conference in New Orleans. 

“Our study showed that even in non-sleepy OSA patients, CPAP usage could reduce the incidence of cardiovascular events and hypertension,” said Ferran Barbé Illa, M.D., of the Hospital Arnau de Vilanova in Lleida, Spain. “We found a statistically significant decrease for those subjects that use CPAP for at least four hours a night.” 

Obstructive sleep apnea is a common condition characterized by repeated episodes of upper airway obstruction during sleep, nocturnal hypoxemia and excessive daytime sleepiness. OSA is also known to be associated with cardiovascular disease and stroke. 

CPAP is the current standard of treatment for patients with symptomatic OSA. CPAP improves daytime sleepiness, and quality of life in patients with OSA. Although daytime sleepiness is one of the main symptoms of sleep apnea, not all patients with OSA complain of it. Therefore, CPAP usage for OSA subjects without sleepiness is unclear. 

To determine whether CPAP would reduce cardiovascular risks in OSA patients without daytime sleepiness, Dr. Barbé Illa and colleagues recruited 724 patients with moderate to severe sleep apnea (AHI>20) and Epworth sleep scores of less than 10, indicating minimal daytime sleepiness despite significant OSA. The patients were randomized to be treated with CPAP or conservative treatment (in which their doctors provided advice on weight control and sleep) and followed for four years. 

At the end of four years, Dr. Barbé Illa and colleagues found that the risk of a having cardiovascular event-such as stroke, angor pectoris, cardiac arrhythmia or peripheral ischemia-or developing hypertension among patients who used CPAP for at least four hours a night was reduced by 25 percent compared to those who did not use CPAP. Among those who had baseline hypertension and used CPAP for four or more hours a night, the risk of a cardiovascular event declined to nearly half of those who did not use CPAP. 

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