A new study suggests that the most common treatment for obstructive sleep apnea (OSA)—the CPAP machine—may lower the risk of heart problems for certain patients, but could actually increase risk for others.
The findings highlight the importance of personalizing treatment rather than using a one-size-fits-all approach.
OSA is a common sleep disorder in which the airway becomes blocked during sleep, causing repeated pauses in breathing.
These interruptions can lower blood oxygen levels, disrupt rest, and strain the heart.
Continuous positive airway pressure (CPAP) machines, which keep the airway open by delivering a constant flow of air, are widely used to improve sleep and reduce symptoms.
But whether CPAP can also protect against heart attacks, strokes, and other cardiovascular problems has been unclear.
Researchers from Mass General Brigham analyzed data from three previous clinical trials involving 3,549 patients with both OSA and cardiovascular disease.
The patients, with a median age of 61, were split evenly between those who used CPAP and those who did not, and were followed for about three years.
The study, published in the European Heart Journal, looked at rates of heart attacks, strokes, and deaths from cardiovascular causes.
When all patients were considered together, the results showed little difference: 16.6% of CPAP users had major heart events compared with 16.3% of non-users. However, when researchers divided patients based on specific “risk markers” from their sleep studies, a different pattern emerged.
Patients were considered high-risk if their breathing disruptions caused large drops in blood oxygen or significant spikes in heart rate during the night.
In this group, CPAP use reduced the risk of major cardiovascular events by about 17%. For patients without these high-risk markers, CPAP use was linked to a 22% increase in risk.
The results were even more pronounced when patients were further sorted by daytime symptoms. Among those who did not report excessive sleepiness during the day, high-risk patients saw a 24% reduction in heart problems with CPAP, while low-risk patients saw their risk increase by 30%.
“This is the first step in making better therapeutic recommendations for patients with obstructive sleep apnea in the future,” said lead author Ali Azarbarzin, Ph.D., of Brigham and Women’s Hospital. “We found a subgroup of patients who experience cardiovascular benefits from CPAP use, but others may not benefit and could even be harmed.”
The researchers caution that more studies are needed before clinical guidelines change. For now, they recommend that people with OSA speak with their doctors about the potential benefits and risks of CPAP, especially in relation to their individual sleep study results and heart health.
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Source: KSR.
