This 2017 article from JAMA addressed the use of positive airway pressure to treat sleep apnea. Both obstructive and central sleep apnea are associated with adverse cardiovascular risk factors along with an increased risk of developing cardiovascular disease. While it is clear that PAP (positive airway pressure) provides symptomatic relief for patients, it remains questionable whether it affects cardiovascular outcomes and death. This systematic review and meta-analysis aimed to answer the following question: does the use of positive airway pressure to treat sleep apnea also reduce the risk of cardiovascular events and death?
The authors systematically searched Medline, Embase, and Cochrane library and ultimately found 10 randomized clinical trials featuring 7,266 patients to determine an answer to their question. They found that there was no significant association of PAP (when compared with no treatment) when it came to the outcome of acute coronary syndrome, stroke, or even vascular death. The results of this study are clinically significant because although there are benefits of PAP use for treatment of sleep apnea (i.e. symptom relief), there is no support for the long-term goal of preventing cardiovascular outcomes or improving patient survival.
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