Benefits of CPAP Therapy

CARDIOVASCULAR MORTALITY AND MORBIDITY RATES IN PATIENTS WITH OSA
  • Marin, et al. Lancet 2005 
  • Study of 1651 Men, over 10 years 
    • 264 Normal (control group) 
    • 377 Snorers (AHI<5) 
    • 403 Untreated mild-Mod OSA (AHI 5 – 30 without EDS) 
    • 235 Untreated Severe OSA (AHI > 30 or AHI> 5 with EDS) 
    • 372 Severe OSA with CPAP Treatment of OSA (AHI > 30, CPAP > 4hrs/day) 
  • CPAP compliance objectively measured
  • Study Fatal and Non-Fatal Cardiac Events (over 10 year period)
FATAL CARDIOVASCULAR EVENTS 

The outcome of the study demonstrated that after 10 years, compared with normal individuals, patients with severe untreated OSA had a 2.5 increased likelihood of having a fatal cardiovascular event over the 10 year time frame after identification (they are the red line on the graph). This number was adjusted for a variety of factors. This list of adjustments is found below.  The incidence of events during the 10 year follow up was 1.06 per 100 person years.  (number of actual events was 25)


Patients who effectively treated their OSA by using CPAP more than 4 hours per night had a significant reduction in incidence of fatal cardiac events over the 10 year time frame (they are the blue line). Their incidence was almost equal to that of the normal group.  The incidence of events during the 10 year follow up was 0.35 per 100 person year (actual number of incidence was 13)


The list of adjustments for the data includes: adjustment for age, diagnostic group, presence of CV disease, hypertension, diabetes, lipid disorders, smoking status, alcohol use, systolic and diastolic blood pressure, blood glucose, total cholesterol, triglycerides and use of anti-hypertension, lipid lowering or anti-diabetic drugs.  

NON-FATAL CARDIOVASCULAR EVENTS

When evaluating non-fatal cardiovascular events, patients with untreated sleep apnea were 2.68 times more likely to develop a non-fatal cardiovascular event. Non-Fatal cardiovascular events include: MI, Stroke and acute coronary insufficiency that needed surgery &/or angiography to clear the vessels. Patients with OSA whose OSA was effectively treated by using CPAP therapy for > 4 hours per night, had a significant reduction in their incidence of non fatal events. 


When evaluating the incidence of non-fatal cardiovascular events, untreated OSA patients had an incidence of 2.13 events per 100 person years (number of events was 50).  

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