Nattapong Jaimchariyatam, Carlos L. Rodriguez, Kumar Budur

Abstract

Objectives:Obstructive sleep apnea (OSA) is associated with significant cardiovascular (CV) morbidity. Continuous positive airway pressure (CPAP) is the standard treatment for moderate to severe OSA, resulting in a reduction in CV morbidity. No studies have compared CV outcomes between CPAP and no CPAP in mild OSA (5PAHI < 15).

Methods:Retrospective cohort study of subjects (ageP18) with mild OSA diagnosed between 2004 and 2006. Subjects with a history of hypertension, angina, stroke and smoking were excluded. Subjects were stratified into two groups: CPAP (n= 93) or no CPAP (n= 162). The mean blood pressures (MBP) were compared 2 years after the diagnosis of OSA was established.

Results:Unmatched for covariates (age, sex, BMI, neck circumference, AHI, arousal index and family h/o CV disorders), subjects with mild OSA on CPAP had a 1.97 point reduction, and no CPAP resulted in a 9.61 point elevation (p< 0.0001) in MBP. With propensity score matching for covariates, the mean difference in MBP was 1.97 (95% CI: 14.03, 9.92;p< 0.0001) with a sensitivity analysis of 2.646. 

Conclusion:This study shows an elevation of the MBP in mild OSA patients who were not treated with CPAP. CPAP treatment in mild OSA patients decreased the MBP over a 2-year period.