Does Positive Airway Pressure Prevent Death or Adverse CV Events in Sleep Apnea?

Positive airway pressure (PAP) improves daytime sleepiness, lowers blood pressure, and has other benefits in patients with obstructive sleep apnea (OSA) or central sleep apnea (CSA). In this meta-analysis of 10 randomized clinical trials (7266 patients; median follow-up, 6–68 months), researchers addressed the value of PAP (usually continuous positive airway pressure, or CPAP) compared with sham PAP or usual care in lowering risk for adverse cardiovascular (CV) outcomes and death.

Adherence to PAP ranged from a mean or median of 1.4 to 6.6 hours daily. Among the seven studies in which only patients with OSA (and not CSA) were enrolled, a single dominant trial contributed the majority of participants (NEJM JW Gen Med Oct 1 2016 and N Engl J M…