The effect of continuous positive airway pressure therapy on early atherosclerosis in patients with severe obstructive sleep apnea-hypopnea syndrome.

PURPOSE: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is the most common sleep-related breathing disorder. Longer term, repeated episodes of hypercapnia and hypoxemia during sleep are associated with inflammatory and atherosclerosis-related factors. The aim of this study was to explore the effect of continuous positive airway pressure (CPAP) therapy on cerebral vasoreactivity and early atherosclerosis in patients with severe OSAHS.

METHODS

Forty-one patients with severe OSAHS were enrolled. The mean follow-up time was 39.8 ± 9.1 months. Cardiovascular risk factors were assessed, and laboratory tests, carotid artery intima-media thickness (CIMT) measurement and cerebrovascular reserve capacity (CRC) measurement were performed. After the baseline examination, 28 patients received CPAP therapy (treated group), which was not available for 13 patients (untreated group). Parameters were compared before and after treatment, between treated and untreated patients.

RESULTS

Cardiovascular risk factors, baseline polysomnographic parameters, laboratory values, CIMT and CRC of the two groups were similar at baseline. At the follow-up, CRC did not differ between the two groups, but CIMT was significantly lower in the treated group than in the untreated group (0.73 ± 0.11 mm vs. 0.84 ± 0.21 mm, p = 0.027). The CIMT of both groups increased significantly during the follow-up period (from 0.65 ± 0.11 mm to 0.73 ± 0.11 mm in the treated group, and from 0.69 ± 0.11 mm to 0.84 ± 0.21 mm in the untreated group), but the increase in the treated group was smaller than in the untreated group (0.09 ± 0.09 mm vs. 0.15 ± 0.15 mm).

CONCLUSION

In patients with severe OSAHS, CPAP treatment significantly reduced the progression of CIMT.