MADISON—Long-term compliance with continuous positive airway pressure (CPAP) therapy may help prevent hypertension and reduce the risk of cardiovascular complications in adults diagnosed with obstructive sleep apnea (OSA), according to a study from the University of Wisconsin School of Medicine and Public Health.
OSA occurs when a person’s airway collapses or is blocked during sleep, resulting in paused or shallow breathing. CPAP therapy, the most common treatment for the disorder, uses a machine to increase air pressure to stop the airway from collapsing. OSA is strongly associated with the development of hypertension, and patients with OSA are at an increased risk of cardiovascular morbidity and mortality.
Researchers followed 47 adults (50 years or younger) with recently diagnosed OSA before and after three months of continuous CPAP therapy. Subjects who had high therapy compliance (>4 hours of use per night) showed significant improvements in systolic and diastolic blood pressures as well as peripheral arterial tone and stiffness—key markers for cardiovascular health.
“We were surprised by how rapidly we saw improvements in patients’ arterial tone and how quickly those benefits were lost after discontinuing therapy,” says Claudia Korcarz, a researcher in the UW department of medicine and principal investigator of the study. “Our findings demonstrate that the vascular effects of sleep apnea are reversible if treated early in the disease process and that high compliance with CPAP may also be able to mitigate the long-term cardiovascular risks associated with chronic exposure to OSA.”
Low-compliance participants (<2.5 hours of use per night) did not get any of the benefits. Compliance is one of the main barriers to successful CPAP therapy, with upwards of 25 percent of all sleep apnea patients unable to comply with or tolerate CPAP therapy, according to the Apnea Positive Pressure Long-term Efficacy Study (APPLES) and other clinical trials.
Obstructive sleep apnea is one of the most common sleep-related breathing disorders, affecting an estimated seven percent of the US adult population. The results will be presented June 4th at the annual meeting of the Associated Professional Sleep Societies in Minneapolis.