Potential Effect of CPAP on Carotid Intima-Media Thickness
Continuous positive airway pressure therapy may significantly decrease carotid intima-media thickness in more severe obstructive sleep apnea.
Patients with severe obstructive sleep apnea (OSA) may experience a decrease in carotid intima-media thickness (CIMT) with continuous positive airway pressure therapy (CPAP), according to a study published in PLoS One.
Researchers performed a meta-analysis of 7 studies, with 2 studies classified as randomized controlled trials, to determine whether CPAP therapy decreased CIMT in patients with OSA.
Study results overall determined CPAP did not have an effect on CIMT before or after therapy in patients with OSA (weighted mean difference [WMD], 0.052; 95% CI, −0.002 to 0.105; z=1.90; P =.057). In addition, the 2 RCTs included in the meta-analysis showed no change in CIMT for participants in the CPAP treatment group when compared with the control group (WMD, 0.002; 95% CI, −0.125 to 0.129; z=0.03; P =.976).
However, when a subgroup analysis was performed, CIMT significantly decreased in patients with more severe OSA after CPAP use (apnea-hypopnea index, ≥50: WMD, 0.073; 95% CI, 0.022-0.124; z=2.80; P =.005) and after therapeutic duration of ≥6 months (WMD, 0.121, 95% CI, 0.019-0.223; z=2.32; P =.021).
The investigators concluded that overall, CPAP therapy did not influence CIMT, but may have beneficial effects for a subgroup of patients with severe OSA if used long term. Therefore, clinicians can provide positive research findings regarding long-term use to encourage treatment compliance in patients with severe OSA.
Chen LD, Lin L, Lin XJ, et al. Effect of continuous positive airway pressure on carotid intima-media thickness in patients with obstructive sleep apnea: a meta-analysis. PLoS One. 2017;12(9):0184293.