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Sleep apnea: CPAP therapy may help reduce heart failure risk

A recent study in the Journal of the American Heart Association examines the relationship between sleep apnea, heart failure, and continuous positive airway pressure therapy (CPAP) therapy.

Sleep apnea is a disorder in which a person stops breathing 5 to 30 times per hour of sleep. Studies have shown that sleep apnea is associated with increased risk of cardiovascular events, including stroke and heart attack, as well as other metabolic disturbances and a poorer quality of life. To relieve symptoms of sleep apnea, patients are often prescribed continuous positive airway pressure (CPAP) therapy which involves using a mask to help keep constant airflow into the airway and prevents closure.

A recent study published in the Journal of the American Heart Association investigated the relationship between sleep apnea, heart failure, and CPAP therapy. The study followed 4.9 million adults from Denmark over a span of 13 years. From this cohort, 40,485 were diagnosed with sleep apnea and 45.2% of this patient population was started on CPAP therapy.

The authors found that sleep apnea patients not using CPAP therapy were associated with an increased risk of heart failure, regardless of age. Specifically, sleep apnea patients over the age of 60 that did not use CPAP therapy had a 38% higher risk of heart failure compared to patients using CPAP therapy.

The current study demonstrated that the use of CPAP therapy in sleep apnea patients was associated with a significantly lower incidence of heart failure. However, the cause and effect relationship between sleep apnea, heart failure, and CPAP therapy is difficult to establish and will require rigorous randomized clinical trials in the future.

Nonetheless, treatment of sleep apnea with CPAP therapy may be an effective strategy in reducing the risk of cardiovascular events and heart failure. It is important to appreciate that CPAP therapy can cause nasal dryness, facial irritation, and overall discomfort. Therefore, clinicians must work closely with patients to ensure that the patients are as comfortable as possible and will adhere to treatment. Furthermore, health care providers must educate patients to ensure they are aware of the potential effectiveness of CPAP therapy in improving cardiovascular outcomes.

Written by Haisam Shah, BSc

References:

(1) CPAP machines for sleep apnea could decrease heart failure risk. American Heart Association News. (2018).
(2) Holt, A., Bjerre, J., Zareini, B., Koch, H., Tønnesen, P., Gislason, G. H., … & Lamberts, M. (2018). Sleep Apnea, the Risk of Developing Heart Failure, and Potential Benefits of Continuous Positive Airway Pressure (CPAP) Therapy. Journal of the American Heart Association7(13), e008684.

Haisam Shah BSc
Haisam Shah BSc
Haisam is a first-year Masters student in the Department of Physiology at the University of Toronto. His research involves understanding the role of cardiac fibroblasts in the progressive development of cardiac fibrosis following a myocardial infarction. He graduated from McGill University with a Bachelors of Science – Honors in Pharmacology, where he had the opportunity of investigating potential combination therapies for Glioblastoma Multiforme.
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