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The changes of AHI after long-term CPAP in patients with comorbid OSA and cardiovascular disease

Yilu Cheng1, Qiong Ou2, Baixin Chen1

  • 1Sleep Center, Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences/Guangdong Provincial Geriatrics Institute, Guangzhou, 510080, China.

Sleep & Breathing = Schlaf & Atmung
|May 13, 2022
PubMed

Insights

Long-term continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) did not significantly alter overall disease severity. However, CPAP showed variable effects based on OSA severity, improving metrics in moderate and severe cases.

Area of Science:

  • Sleep Medicine
  • Cardiovascular Health
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) is a common sleep disorder associated with cardiovascular and cerebrovascular diseases.
  • Continuous positive airway pressure (CPAP) is a primary treatment for OSA, aiming to improve sleep quality and reduce health risks.
  • The long-term efficacy of CPAP in improving OSA disease severity, particularly in patients with existing cardiovascular conditions, requires further evaluation.

Purpose of the Study:

  • To assess the long-term impact of continuous positive airway pressure (CPAP) on the disease severity of obstructive sleep apnea (OSA).
  • To investigate whether CPAP treatment influences key indicators of OSA severity over an extended period.
  • To explore potential differential effects of CPAP based on the baseline severity of OSA.

Main Methods:

  • Analysis of data from the Sleep Apnea and Cardiovascular Events (SAVE) study, involving patients aged 45-75 with cardiac or cerebrovascular disease.
  • Randomization of participants to either CPAP plus standard care or standard care alone, with follow-up lasting several years.
  • Home sleep apnea testing (HSAT) conducted at baseline and study conclusion to measure changes in apnea-hypopnea index (AHI) and other OSA indicators.

Main Results:

  • While the apnea-hypopnea index (AHI) decreased in both CPAP and usual care groups, there was no significant difference between them.
  • An improvement in the lowest oxygen saturation (nadir SpO2) was observed in the CPAP group but not the usual care group.
  • Subgroup analysis indicated that CPAP improved AHI in moderate OSA and nadir SpO2 in severe OSA.

Conclusions:

  • Long-term CPAP use did not lead to clinically significant overall improvements in AHI or oxygen desaturation index (ODI) in this patient cohort.
  • The study highlights that the benefits of CPAP may be stratified by OSA severity, with notable improvements observed in specific subgroups.
  • Further research is warranted to understand the nuanced effects of CPAP on OSA severity and associated cardiovascular outcomes.
Abstract

Keywords:
AHILong-term CPAPOSAOxygen saturation

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