Cardiovascular mortality in women with obstructive sleep apnea with or without continuous positive airway pressure...

Area of Science:

• Cardiology
• Sleep Medicine
• Public Health

Background:

• Obstructive sleep apnea (OSA) is a known risk factor for cardiovascular death in men.
• The association between OSA and cardiovascular mortality in women remains unclear.

Purpose of the Study:

• To determine if OSA is a risk factor for cardiovascular death in women.
• To assess the impact of continuous positive airway pressure (CPAP) treatment on this risk.

Main Methods:

• Prospective, observational cohort study involving 1116 women referred for suspected OSA.
• Women were categorized into control (apnea-hypopnea index [AHI] <10), mild-to-moderate OSA (AHI 10-29), or severe OSA (AHI ≥30) groups.
• Participants were classified as CPAP-treated (adherence ≥4 hours/day) or untreated, with follow-up until December 2009 for cardiovascular death.

Main Results:

• Severe OSA was associated with significantly higher cardiovascular mortality rates compared to controls (3.71 vs. 0.28 per 100 person-years).
• Untreated severe OSA showed a hazard ratio of 3.50 for cardiovascular death (fully adjusted).
• CPAP treatment in severe OSA patients demonstrated a trend towards reduced risk (hazard ratio 0.55), though not statistically significant in this observational study.

Conclusions:

• Severe obstructive sleep apnea is linked to an increased risk of cardiovascular death in women.
• Adequate CPAP treatment appears to potentially reduce this elevated cardiovascular mortality risk.
• Further randomized controlled trials are warranted to confirm the benefits of CPAP in women with severe OSA.