0540 Survival Benefit of Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea: A propensity-score matched analysis. (12th April 2019)

• Record Type: Journal Article
• Authors: Nakamura, Kei; Nakamura, Hiroshi; Iseki, Chiho; Toyama, Kazuyo; Iseki, Kunitoshi
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A216
• Page End: A216
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.538
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Continuous positive airway pressure (CPAP) improves quality of life (QOL) in patients with obstructive sleep apnea (OSA). However, the long-term benefit all-cause mortality and cardiovascular death remained to be shown. Methods: We conducted a retrospective, observational study in our sleep clinic in Okinawa, Japan. All patients who were performed full-scale polysomnography (PSG) from September 1990 to December 2010 were included. Patients whose AHI <5 in PSG, central sleep apnea syndrome and those whose follow-up periods < 1month were excluded. Patients were categorized CPAP user and CPAP non-user. Outcomes such as death (date and causes of death) were surveyed during 2012 to 2013 by chart review, telephone call, and letter of inquiry. Propensity score matching was performed to balance baseline characteristics such as age, sex, life-style (smoking, drinking), comorbid conditions including cardiovascular disease and/or stroke, other comorbid conditions, ESS and AHI between CPAP user and CPAP non-user. The primary outcome was the risk of all-cause mortality between matched two groups. Secondary outcome was the risk of death from cardiovascular disease. Results: A total of 10, 856 patients were performed PSG and 6, 647 patients fulfilled the criteria. Propensity score matching revealed 1, 137 of 4, 419 CPAP user and 1, 137 of 2, 128 CPAP non-user. Mean age of the patients and gender were 52.4 years and 79% in men, respectively. After a mean follow-up of 79 months, the death from all cause had occurred in 53 patients in the CPAP user and in 83 patients in the CPAP non-user. The leading cause of death was malignancy in each group. The hazard ratios for all-cause mortality and death from cardiovascular disease between CPAP user and CPAP non-user were 0.64 (95% confidence interval, 0.45-0.89) and 0.80 (95% CI, 0.38-1.70), respectively. Conclusion: Our long-term follow-up study suggest that CPAP use may improve all-cause mortality in patients with OSA. Support (If Any): None