Sleep apnoea treatment and heart risks

People experiencing sleep apnoea, or brief episodes when breathing stops, are often treated with continuous positive airway pressure (CPAP) to help them breathe properly during the night. While rather cumbersome and inconvenient, the treatment is worth sticking to, especially for people who have heart disease.Treatment of obstructive sleep apnoea reduces cardiovascular events such as heart attacks or the need for heart surgery among people who already have coronary heart disease.Researchers from Ambroise Pare Teaching Hospital in Paris, France, compared rates of new cardiovascular events over a five-year period in 25 patients with coronary artery disease (CAD) whose sleep apnoea was treated and in 29 who refused treatment. CPAP was the treatment in 21 patients, while 4 underwent upper airway surgery.Six treated patients (24 per cent) and 17 in the untreated group (58 per cent) had at least one cardiovascular event during follow-up. Three heart-related deaths that occurred were all in the untreated group. One of three treated patients who discontinued CPAP after 18 months had a coronary 13 months later, but the other two remained free of new cardiovascular events.These results are useful in convincing reluctant sleep apnoea patients to undergo CPAP. One third of coronary artery disease patients have obstructive sleep apnoea. Moreover, sleep apnoea is associated with sleepiness, depression, traffic accidents, and hypertension. If physicians are not convinced that treating sleep apnoea is associated with better outcomes in coronary artery disease patients, they should still offer the treatment to such patients because it can give them a better quality of life.