Ongoing use of CPAP may reduce mortality risk in people with obstructive sleep apnea
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Ongoing continuous positive airway pressure use in the first year after starting therapy was associated with lower risk for all-cause mortality in patients with obstructive sleep apnea, according to research published in Chest.
“Despite the reported association between OSA and mortality, randomized clinical trials evaluating the effects of treating OSA on cardiovascular events and all-cause death have not demonstrated any beneficial effect of CPAP therapy, the gold standard treatment for moderate to severe OSA,” Jean-Louis Pépin, MD, professor of clinical physiology at Grenoble Alpes University in France, and colleagues wrote.
Researchers analyzed data from 88,007 adults with OSA (mean age, 60 years; 64% men) using the French national health insurance reimbursement system, which includes comprehensive information on health spending reimbursements for residents. All patients were new CPAP users.
OSA diagnoses were based on specific disease codes, and CPAP prescriptions were identified using specific treatment method codes. Patients who terminated CPAP therapy, defined as CPAP reimbursement cessation, in the first year (mean age, 59 years; 36% women) were matched with patients who continued CPAP use (mean age, 60 years; 36.6% women). The primary outcome was all-cause mortality.
During the 3-year observation period, 3.6% of patients who terminated CPAP therapy died compared with 2.3% of patients who continued therapy.
Continued CPAP use was associated with a significantly lower risk for all-cause mortality compared with termination of CPAP (HR = 0.61; 95% CI, 0.57-0.65).
In addition, researchers reported incident heart failure was less common among those who continued CPAP use compared with those who terminated therapy (HR = 0.77; 95% CI, 0.71-0.82).
“This finding adds to a growing body of evidence for the beneficial effects of CPAP use on survival,” the researchers wrote. “Additional research is needed to clarify the impact of CPAP on specific causes of death and to determine the relationship between hours of CPAP use and mortality benefit.”