“PAP therapy is the treatment of choice in patients with OSA, delivering marked improvements in patient-reported quality-of-life outcomes,” said Dr Atul Malhotr (University of California San Diego, CA, USA). “However, the impact of PAP therapy on all-cause mortality in this population is not clear.” The current systematic literature review and meta-analysis evaluated the association between all-cause mortality and PAP therapy in patients with OSA [1]. The authors included 10 randomised trials and 17 non-randomised studies with all-cause mortality as outcome measure, resulting in a total sample size of 1,164,880 patients. In addition, they included 6 randomised controlled trials and 5 non-randomised-controlled studies with cardiovascular mortality as an outcome measure.
Overall, PAP therapy had a significant impact on all-cause mortality in patients with OSA (HR 0.63; 95% CI 0.56–0.72; P<0.001). Dr Malhotra mentioned that there was a trend towards a better treatment effect if the treatment adherence was higher: the treatment effect was 16% greater in patients using PAP therapy for at least 4 hours per night compared with patients who used PAP therapy for fewer than 4 hours per night. Next, PAP therapy reduced cardiovascular mortality in patients with OSA (HR 0.46; 95% CI 0.29–0.73; P=0.001).
The current study thus indicates that PAP therapy is an effective treatment to reduce all-cause mortality in patients with OSA across diverse populations.
- Malhotra A, et al. All-cause mortality in OSA: systematic literature review including randomized trials and confounding adjusted non-randomized controlled studies and meta-analysis of PAP treatment. Sleep apnea unplugged: navigating a myriad of health outcomes. ATS 2024, 17–22 May, San Diego, USA.
Posted on