Treating Sleep Apnea with CPAP Therapy is Associated with Lower Risk of Heart Problems
Penn Nursing’s Amy Sawyer, PhD, RN, Associate Professor of Sleep & Health Behavior in the Department of Biobehavioral Health Sciences, is co-lead investigator for a study showing that patients with untreated, moderate to severe obstructive sleep apnea had a higher risk of experiencing a cardiovascular event, but the risk of incident heart problems was decreased in those who used CPAP therapy. The findings were published recently in an online supplement of the journal Sleep and were presented as a poster during Virtual SLEEP 2021.
Nearly 30 million adults in the U.S. have obstructive sleep apnea, a chronic disease that involves the repeated collapse of the upper airway during sleep. Common warning signs include snoring and excessive daytime sleepiness. A common treatment is CPAP therapy, which uses mild levels of air pressure, provided through a mask, to keep the throat open during sleep.
Results of the observational study show that people with moderate to severe sleep apnea and no record of CPAP use were 71% more likely than those without sleep apnea to experience incident myocardial infarction, stroke, unstable angina, heart failure or cardiovascular death. Compared with the risk of heart problems in people with untreated sleep apnea, the risk of experiencing a cardiovascular event was 32% lower in patients with any severity of sleep apnea who used CPAP therapy, and it was 44% lower in those with moderate to severe sleep apnea who used CPAP.
“Our big data study results emphasize the importance of treating sleep apnea with CPAP to reduce cardiovascular risks with greater risk reduction in more severe sleep apnea,” said Sawyer. “It is not only important to identify and diagnose sleep apnea in adults seeking care for sleep problems, but also help them get started and stay on CPAP treatment to realize these cardiovascular benefits.”
The researcher team analyzed the electronic health records of patients who received a sleep study between January 2018 and September 2020 through the Kaiser Permanente Southern California health system. The sample comprised 11,145 people without sleep apnea, 13,898 patients with sleep apnea and a record of any CPAP use, and 20,884 patients with sleep apnea and no record of CPAP use. To be eligible for the analysis, patients had to be free of cardiovascular disease for one year prior to their sleep apnea diagnosis. Results were adjusted for baseline age, sex, body mass index, race/ethnicity, comorbidities, and use of anti-hypertensives and lipid-lowering medications. The median follow-up period was 262 days.
The study is a multi-site collaboration between Kaiser Permanente Southern California and Penn Nursing. It was supported by funding from the American Academy of Sleep Medicine and the American Heart Association.