Jama logo Patients suffering with obstructive sleep apnea (OSA) seem to face repeated episodes of upper airway obstruction during sleep, nocturnal hypoxemia along with excessive daytime sleepiness. A recent study undertaken by a scientist at the Hospital Arnau de Vilanova in Lleida, Spain claims that among non-sleepy patients with OSA, treatment with continuous positive airway pressure (CPAP) can possibly reduce the number of cardiovascular events and hypertension. It is known that, OSA is possibly associated with cardiovascular disease and stroke.

Usually, patients with OSA are treated with CPAP, as it affects day time sleepiness and helps improve the quality of life. But, the utilization of CPAP, for improving sleepiness amongst patients with OSA, remains questionable. This is because, though daytime sleepiness is considered to be a common symptom of sleep apnea, not all patients with OSA reported to be suffering from the same.

“Our study showed that even in non-sleepy OSA patients, CPAP usage could reduce the incidence of cardiovascular events and hypertension. We found a statistically significant decrease for those subjects that use CPAP for at least four hours a night,” commented Ferran Barbé Illa, M.D., of the Hospital Arnau de Vilanova in Lleida, Spain.

The study encompassed 724 patients, with moderate to severe sleep apnea and Epworth sleep scores of less than 10, which highlighted a minimal daytime sleepiness, in spite of extreme OSA. The study took place, for a period of four years, as patients were randomized to be provided with treatment of CPAP and with conservative treatment. In conservative treatment, the patients were given advice on weight control and sleep.

Dr. Barbé Illa remarked, “The positive effects of CPAP on cardiovascular incidence are not observed across the entire range of patients with OSA. This study aimed to determine the effects of CPAP treatment on OSA patients to improve clinical guidelines for OSA treatment. It is plausible that long-term and adequate treatment with CPAP may decrease the development of cardiovascular events in non-sleepy patients and, therefore, also in these patients is recommended to indicate the treatment with CPAP, despite the lack of daytime symptoms.”

A reduction of 25 percent was witnessed among patients facing a risk of experiencing a stroke, angor pectoris, cardiac arrhythmia or peripheral ischemia or developing hypertension after four years by the authors. These were the patients who used CPAP for at least four hours a night than those who did not use CPAP.

The patients with baseline hypertension, who used CPAP for four or more hours a night, displayed an almost half reduction of risk, than those who did not use CPAP. Investigators further anticipate conducting a study to determine the OSA physiopathology and effectiveness of CPAP treatment, for OSA patients.

The study was reported at the ATS 2010 International Conference in New Orleans.