According to research people suffering from obstructive sleep apnoea (OSA) can minimise their risk of dying from cardiovascular disease by using a continuous positive airway pressure (CPAP) machine at night.
According to a pilot research presented at the European Respiratory Society International Congress, CPAP may be more effective than a weight reduction medicine in lowering plaque buildup in the arteries surrounding the heart.
People with OSA frequently snore loudly, their breathing stops and begins throughout the night, and they may wake up multiple times. This can reduce the amount of oxygen in the blood and create fatigue. It can also raise the risk of hypertension, stroke, heart disease, and type 2 diabetes.
People with OSA are given CPAP machines to help them sleep better. They function by blowing air via a face mask during the night to keep the user's airways open. However, studies on the effects of CPAP on cardiovascular disease have yielded conflicting results.
Dr Jordi de Batlle of the Institut de Recerca Biomèdica de Lleida (IRBLleida) in Lleida, Spain, presented the heart disease study. He and his colleagues tracked down all 3,638 OSA patients in Catalonia who had decided to discontinue CPAP use in 2011. They compared these to 3,638 OSA patients who continued to use CPAP until at least 2015 or until death.
Dr. de Batlle said, “Our results suggest that CPAP treatment can help most OSA patients by preventing cardiovascular problems such as heart disease and stroke. This is a plus, as CPAP treatment already helps most OSA patients by reducing sleepiness and improving their quality of life. Based on these findings, we should encourage people with OSA to keep using their CPAP machines.”
The pilot study was presented by Dr Cliona O’Donnell, a specialist registrar in respiratory medicine at St. Vincent’s University Hospital and University College Dublin, Ireland. She and her colleagues conducted a study with 30 patients suffering from OSA who underwent a computerised tomography (CT) coronary angiogram to assess any signs of narrowing in the blood vessels that supply the heart.
The patients were then randomly assigned to 24 weeks of treatment either using a CPAP machine at night, injections with the weight loss drug liraglutide, or both together.
Patients who showed signs of coronary artery disease in their first scan underwent a repeat scan at the end of the 24 weeks of treatment. Researchers used an artificial intelligence program to analyse the patients’ scans.
The patients who were treated with CPAP and those treated with CPAP and weight loss injections experienced reductions in the plaque build-up in their arteries and a reduction of inflammation in their aorta (the main artery that carries blood from the heart to the rest of the body). Patients who were treated with weight loss injections only did not experience these effects.
Dr O’Donnell said, “Continuous positive airway pressure works by keeping patients’ airways open while they sleep. This stops fluctuations in oxygen levels in the blood that can exacerbate cardiovascular disease.
“Although this is a pilot study, meaning we cannot draw firm conclusions, we found improvements in some early signs of cardiovascular disease with CPAP treatment. This should now be further evaluated in larger studies.”
Professor Sophia Schiza, who is secretary of the European Respiratory Society’s group assembly on sleep-disordered breathing and was not involved in the research, said, “We know that people with obstructive sleep apnoea are at a higher risk of cardiovascular problems, but there are conflicting data on the effects of CPAP on reducing this risk.
However, research using real-world data is showing that CPAP adherence is one of the key predictors for reducing cardiovascular risk and for better outcomes in general. Here we have two studies: one large study showing that CPAP could help lower the risk of developing or dying from cardiovascular disease in people suffering from OSA and another small study suggesting that CPAP could be more beneficial than weight-loss therapy for people suffering from OSA.
OSA is an extremely common disease, with consequences for people’s daytime functioning and the health of their hearts, blood vessels and metabolism. One of the treatment options is CPAP, and the more the patients use CPAP every night, the greater the reduction in cardiovascular illness and death. Therefore, there is a need for individualised treatment plans, patient engagement, educational activities and close treatment follow-up in order to increase adherence to long-term treatment and improve outcomes for patients.” (ANI)
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