Effects of Continuous Positive Airway Pressure on Cardiovascular Risk in Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) has been shown to significantly promote cardiovascular risk, in part possibly due to activation of the sympathetic nervous system during respiratory events in sleep and its subsequent effects on blood pressure and heart rate. Previous studies have also found associations between long term variability of blood pressure and heart rate with cardiovascular outcomes. We hypothesize that compliance to continuous positive airway pressure (CPAP) therapy will decrease the incidence of cardiovascular events in a dose dependent fashion in patients with moderate to severe OSA. This retrospective study population consists of patients from the Jefferson Sleep Center with moderate to severe OSA. CPAP adherence was used as both a categorical (adherent/non-adherent) and continuous predictor variable. The primary endpoint for the parent study is major adverse cardiovascular events. In this subproject, we focused on the secondary cardiovascular risk endpoints: blood pressure and heart rate variability, assessed using data collected from primary care/sleep medicine office visits. Our study hypothesis is that increased CPAP usage will be associated with a decrease in cardiovascular events along with decreased blood pressure and heart rate variability, which may partially mediate improved cardiovascular outcomes as well. Our pilot study findings in 10 patients [insert pending data here] support this hypothesis. These findings highlight the importance of CPAP therapy in managing both OSA and long-term cardiovascular health and complications. Further elucidating the role of cardiovascular risk factors in OSA in combination with the effects of CPAP usage will be clinically significant for this patient population