Journal article
Continuous positive airway pressure and adverse cardiovascular events in obstructive sleep apnea: are participants of randomized trials representative of sleep clinic patients?
Sleep (New York, N.Y.), Vol.45(4)
2022
PMID: 34739082
Abstract
Study Objectives
Randomized controlled trials (RCTs) have shown no reduction in adverse cardiovascular (CV) events in patients randomized to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA). This study examined whether randomized study populations were representative of OSA patients attending a sleep clinic.
Methods
Sleep clinic patients were 3,965 consecutive adults diagnosed with OSA by in-laboratory polysomnography from 2006 to 2010 at a tertiary hospital sleep clinic. Characteristics of these patients were compared with participants of five recent RCTs examining the effect of CPAP on adverse CV events in OSA. The percentage of patients with severe (apnea-hypopnea index, [AHI] ≥ 30 events/h) or any OSA (AHI ≥ 5 events/h) who met the eligibility criteria of each RCT was determined, and those criteria that excluded the most patients identified.
Results
Compared to RCT participants, sleep clinic OSA patients were younger, sleepier, more likely to be female and less likely to have established CV disease. The percentage of patients with severe or any OSA who met the RCT eligibility criteria ranged from 1.2% to 20.9% and 0.8% to 21.9%, respectively. The eligibility criteria that excluded most patients were preexisting CV disease, symptoms of excessive sleepiness, nocturnal hypoxemia and co-morbidities.
Conclusions
A minority of sleep clinic patients diagnosed with OSA meet the eligibility criteria of RCTs of CPAP on adverse CV events in OSA. OSA populations in these RCTs differ considerably from typical sleep clinic OSA patients. This suggests that the findings of such OSA treatment-related RCTs are not generalizable to sleep clinic OSA patients.
Details
- Title
- Continuous positive airway pressure and adverse cardiovascular events in obstructive sleep apnea: are participants of randomized trials representative of sleep clinic patients?
- Authors/Creators
- Ayesha Reynor - The University of Western AustraliaNigel McArdle - Sir Charles Gairdner HospitalBindiya Shenoy - The University of Western AustraliaSatvinder S Dhaliwal - Sir Charles Gairdner HospitalSiobhan C Rea - Sir Charles Gairdner HospitalJennifer Walsh - The University of Western AustraliaPeter R Eastwood - Flinders UniversityKathleen Maddison - The University of Western AustraliaDavid R Hillman - The University of Western AustraliaIvan Ling - Sir Charles Gairdner HospitalBrendan T Keenan - University of PennsylvaniaGreg Maislin - University of PennsylvaniaUlysses Magalang - The Ohio State University Wexner Medical CenterAllan I Pack - University of PennsylvaniaDiego R Mazzotti - University of Kansas Medical CenterChi-Hang Lee - National University of SingaporeBhajan Singh - Sir Charles Gairdner Hospital
- Publication Details
- Sleep (New York, N.Y.), Vol.45(4)
- Grant note
- P01 HL094307 / NHLBI NIH HHS
- Identifiers
- 991005592659507891
- Copyright
- © The Author(s) 2021
- Murdoch Affiliation
- Vice Chancellery
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.137 Sleep Science & Circadian Systems
- 1.137.382 Obstructive Sleep Apnea
- Web Of Science research areas
- Clinical Neurology
- Neurosciences
- ESI research areas
- Neuroscience & Behavior