Acute response to 7-day therapy with CPAP in patients with moderate to severe obstructive sleep apnea and cardiac arrhytmia

Abstract

IntroductionObstructive Sleep Apnea (OSA) has been associated with an elevated risk of cardiac arrhythmia. Continuous positive airway pressure (CPAP) is the selected treatment for moderate to severe OSA and could improve arrhythmias in the long term. However, the acute effect of CPAP has not been studied in detail.MethodsWe conducted a prospective study with 25 patients with moderate to severe OSA diagnosed by home respiratory polygraphy (RP) and arrhythmia and/or pauses in 24-hour Holter ECG. We analyzed inflammatory parameters and the rate of arrhythmias/pauses after 7 days of auto-adjusting CPAP.Results92.5% of the patients were men with a mean age of 61.7±1.9 years. Body mass index (BMI) was 59.5±2.2 kg/m2, with a mean apnea hypopnea index (AHI) of 37.7±3.8 events/hour (ev/h), and a residual AHI (AHIr) of 5.3±0.53 ev/h. After short treatment with CPAP we observed a tendency to improvement in both the severity and number of ventricular extrasystoles (VE) (1595.0±850.3 vs. 926.4±434.5 respectively), pauses and the inflammatory parameters (CRP 3.9±3.1 vs. 1.7±1.2, glycemia 131.4±11.6 vs. 121.9±9.8, HOMA 24.4±3.1 vs. 21.7±2.8, insulin 7.6±1.4 vs. 7.2±1.2 (p>0.5).ConclusionWe didn't find significant changes in pauses, VE and inflammatory parameters with CPAP short therapy in CPAP naive patients recently diagnosed with OSA.

Impact of 1-week preoperative auto-CPAP treatment on postoperative outcomes in patients undergoing heart valve replacement surgery: a prospective randomized controlled trial

“…Altmay et al ( 27 ) observed patients with normal preoperative pulmonary function and CPAP use did not improve lung function after cardiac surgery. Furthermore, short-term CPAP treatment cannot reduce postoperative cardiac arrhythmias ( 28 , 29 ). There are many factors that induce postoperative arrhythmias, pacemaker use, reintubation, and pneumonia, such as poor cardiac function, hypoxia, and malnutrition.…”

Screening tools for obstructive sleep apnea in extremely obese women during pregnancy

“…In this population, most groups have evaluated the long-term benefits of the use of continuous positive airway pressure, although no studies have demonstrated a positive short-term impact. 4 By inference, at the timing considered, screening and detection may be useless if no effective therapy can be used.…”