Continuous Positive Airway Pressure Versus Nocturnal Oxygen in Obstructive Sleep Apnea: A Propensity Score Matching...

Area of Science:

• Pulmonology
• Sleep Medicine
• Cardiovascular Risk Management

Background:

• Obstructive sleep apnea (OSA) significantly impacts quality of life and elevates cardiovascular risk.
• Nocturnal oxygen therapy (NOT) presents an alternative for patients unable to tolerate continuous positive airway pressure (CPAP) therapy.

Purpose of the Study:

• To compare the five-year survival rates between patients with obstructive sleep apnea (OSA) treated with NOT and continuous positive airway pressure (CPAP).
• To evaluate the long-term efficacy of CPAP versus NOT in managing OSA.

Main Methods:

• Retrospective cohort study utilizing propensity score matching (PSM) to minimize selection bias.
• Analysis included 497 patients diagnosed with OSA, matched into two groups: CPAP therapy (303 patients) and NOT (194 patients).
• A matched cohort of 370 patients (185 per group) was established using PSM, with balance assessed via standardized mean differences.

Main Results:

• The CPAP-treated group exhibited a significantly lower residual Apnea-Hypopnea Index (3.9 vs. 15; p < 0.001), indicating superior physiological control.
• CPAP therapy was associated with a substantially reduced risk of mortality compared to NOT (weighted logistic regression OR = 0.11; p = 0.004).
• Propensity score matching further confirmed CPAP's benefit, showing a significant reduction in mortality risk (ATT = -0.12; p = 0.030).

Conclusions:

• Patients with OSA treated with CPAP demonstrated higher five-year survival rates compared to those receiving supplemental oxygen.
• The findings support CPAP as the preferred first-line therapy for obstructive sleep apnea due to its favorable association with long-term outcomes.
• CPAP therapy offers better physiological control and improved survival benefits for individuals with OSA.