Is obstructive sleep apnea associated with cardiovascular and all-cause mortality?
Xiahui Ge1, Fengfeng Han, Yanxi Huang
1Department of Respiratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, China.
Plos One
|August 13, 2013
Summary
Severe obstructive sleep apnea (OSA) significantly increases the risk of death from all causes and cardiovascular events. Continuous positive airway pressure (CPAP) treatment may reduce cardiovascular mortality.
Area of Science:
- Cardiology
- Sleep Medicine
- Epidemiology
Background:
- Inconsistent findings exist regarding the link between obstructive sleep apnea (OSA) and mortality.
- Prospective observational studies are needed to clarify OSA's independent predictive value for mortality.
Purpose of the Study:
- To conduct a meta-analysis investigating OSA as an independent predictor of cardiovascular and all-cause mortality.
- To analyze data from prospective observational studies.
Main Methods:
- A systematic literature search was performed in Medline and Embase up to December 2012.
- Six prospective observational studies involving 11,932 patients were included.
- Pooled hazard ratios (HR) and 95% confidence intervals (CI) were calculated, with subgroup analyses based on OSA severity.
Main Results:
- Severe OSA was associated with a significantly increased risk of all-cause mortality (HR 1.90; 95% CI, 1.29 to 2.81).
- Severe OSA also showed a strong association with increased cardiovascular mortality (HR 2.65; 95% CI, 1.82 to 3.85).
- Continuous positive airway pressure (CPAP) treatment did not show a significant difference in cardiovascular mortality compared to healthy subjects (HR 0.82; 95% CI, 0.50 to 1.33).
Conclusions:
- Severe obstructive sleep apnea is a significant independent predictor of future cardiovascular and all-cause mortality.
- Continuous positive airway pressure (CPAP) treatment appears to be associated with a reduction in cardiovascular mortality.
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