Assessment of carotid artery wall in patients with OSA syndrome and the effect of CPAP on its thickness

Background: In patients with Obstructive sleep apnea (OSA), the risks of fatal and non-fatal cardiovascular diseases and coronary artery disease are increased and measuring carotid intima-media thickness (CIMT) can assess these complications. Aim: Studying the effect of OSA syndrome in the carotid artery wall thickness as an indicator to cardiovascular complications, and the effect of CPAP on these changes. Subjects and methods: Polysomnography (PSG) was done for 45 patients; 29 patients of them proved to have OSA, and 10 obese subjects with normal PSG were included as a control group. All of them had ultrasonographic assessment of CIMT. 17 patients with OSA used CPAP overnight for 6 months and the CIMT was remeasured. Results: 29 were diagnosed with OSA (12 severe, 9 moderate and 8 mild OSA). There was a highly significant difference (p < 0.01) in CIMT between patient and control groups, and also between severe and mild OSA patients with non-significant difference (p > 0.05) between severe and moderate OSA. Regarding the different risk factors predispose to atherosclerosis, only factors related to OSA syndrome were correlated with CIMT. There was a highly significant reduction (p < 0.01) in CIMT after six months of CPAP usage. Conclusions: CIMT as a marker of atherosclerosis is significantly increased in patients with OSA and the use of CPAP in those patients is very important not only for improving sleep efficiency but also for reducing cardiovascular complications associated with OSAS