For their study, Dr. Martnez-Garca and colleagues enrolled 939 elderly patients referred with suspected sleep apnea between 1999 and 2007, and followed these patients through 2009. Patients were divided into four groups: a control group without OSA; mild to moderate OSA patients without CPAP treatment; patients with severe OSA without CPAP treatment; and patients with any degree of OSA who received CPAP treatment. Complete health histories, including cardiovascular and respiratory data, were obtained from all patients at enrolment and mortality causes were obtained from death certificates. Fatal cardiovascular events included sudden death, stroke, heart failure (HF), cardiac arrhythmias and ischemic heart disease (IHD). Median follow-up time was 69 months.
The researchers found that untreated severe OSA (but not untreated mild-moderate OSA) was independently associated with all-cause and cardiovascular mortality, as well as stroke and HF mortality, but not with IHD mortality. In addition, they found that CPAP treatment reduced these increased risks of mortality in OSA patients.
Dr. Martnez-Garca said the results were not entirely unexpected, since anecdotal evidence and several smaller studies have indicated CPAP offers improved outcomes in certain patients, notably patients at risk for stroke.
"Our study provides an excellent scientific basisfor further studies in this area given a lack of scientific evidence on the impact of sleep apnea and the role of CPAP treatment in elderly patients," Dr. Martnez-Garca said. "These findings clearly support the fact that treatment with CPAP is effective in elderly people and therefore, within logical limits, it must be a treatment that is offered to patients with severe or symptomatic OSA regardless
|Contact: Keely Savoie|
American Thoracic Society