Khan SU, et al. - This study assessed the impact of continuous positive airway pressure (CPAP) therapy on the incidence of major adverse cardiovascular events (MACE) in patients with moderate-to-severe obstructive sleep apnoea (OSA). Findings demonstrated that CPAP therapy might attenuate MACE and stroke among subjects with CPAP time exceeding 4 h/night.

Methods

• Researchers identified a total of 235 articles using MEDLINE, EMBASE and Cochrane library (inception–December 2016) and references contained in the identified articles.

Results

• Final analysis included 7 randomized controlled trials (RCTs).
• Data reported that non-significant 26% relative risk reduction in MACE with CPAP was demonstrated in the analysis of 4268 patients [risk ratio (RR) 0.74; 95% confidence interval (CI) 0.47–1.17; P = 0.19, I² = 48%].
• Increased CPAP usage time yielded significant risk reduction in MACE and stroke, as indicated by a series of sensitivity analyses.
• According to findings of subgroup analysis, 57% reduction occurred in the risk of MACE as a result of CPAP adherence for ≥4 hours (h)/night (RR 0.43; 95% CI 0.23–0.80; P = 0.01,I² = 0%).
• Furthermore, no beneficial impact of CPAP therapy was observed on myocardial infarction (MI), all-cause mortality, atrial fibrillation/flutter (AF), or heart failure (HF) (P > 0.05).
• Also, it was noted that CPAP had positive impact on mood and attenuated the daytime sleepiness [Epworth Sleepiness Scale (ESS): mean difference (MD) -2.50, 95% CI -3.62, -1.39; P < 0.001, I² = 81%].