Treating Sleep Apnea With CPAP Therapy Lowers the Risk of Heart Problems, COVID-19

Recent studies by Kaiser Permanente in Southern California show patients with untreated, moderate to severe obstructive sleep apnea (OSA) had a higher risk of experiencing cardiovascular issues and COVID-19 infection. However, the risk of these health issues were decreased in those who used CPAP therapy.

According to the American Academy of Sleep Medicine, nearly 30 million adults in the U.S. have obstructive sleep apnea.

In patients who experience heart failure, stroke or other cardiovascular issues, results from one of the studies show they were 71% more likely to face these issues if they have moderate to severe sleep apnea and no record of CPAP use than those without sleep apnea. Compared with the risk of heart problems in people with untreated sleep apnea, the risk of experiencing a cardiovascular event was 32% lower in patients with any severity of sleep apnea who used CPAP therapy, and it was 44% lower in those with moderate to severe sleep apnea who used CPAP.

Lead author of the study and Assistant Professor in the division of medical informatics in the department of internal medicine at the University of Kansas Medical Center, Diego R. Mazzotti, Ph.D., said in a release effects of CPAP found were "stronger in patients with moderate to severe sleep apnea, as well as in patients who used CPAP, on average, greater than 4 hours per night."

Researchers analyzed the electronic health records of patients who received a sleep study between January 2018 and September 2020 through Kaiser Permanente. The sample was made of 11,145 people without sleep apnea, 13,898 patients with sleep apnea and a record of any CPAP use, and 20,884 patients with sleep apnea and no record of CPAP use.

In an additional study by Kaiser from 2015 to 2020, it was stated patients with obstructive sleep apnea who have received CPAP therapy can avoid higher risks of getting COVID-19.

The data showed a dose-response association of OSA severity on infection rate with patients with untreated mild OSA with a 2% rate of COVID-19 infection, while patients with severe untreated OSA had a COVID-19 infection rate of 2.4%, which was significantly higher than those treated with PAP at 1.4%.

Patients who engaged in PAP therapy with good adherence had lower COVID-19 infection rates at 1.3% rather than patients without OSA resulting at 1.7%. The study also identified obesity, other chronic illnesses, and being on Medicaid to higher COVID-19 infection rates. Black and Hispanic patients also had higher COVID-19 infection rates, according to the study.

“These findings demonstrate the critical importance for people with OSA to receive and stay on PAP therapy,” said ResMed’s Chief Medical Officer, Carlos M. Nunez, M.D., in a release. “In addition to COVID-19, OSA can increase a person’s risk for an array of chronic diseases, so it’s necessary for healthcare providers to educate patients on the importance of proper CPAP use so they can get optimal sleep, which may help keep their immune systems healthy.”

This study collected data on nearly 82,000 U.S. patients who were evaluated for sleep disorders at Kaiser Permanente’s sleep clinic. Of those, 1,493 tested positive for COVID-19 infection. The data collected includes patients’ electronic health records, sleep study findings, and remotely collected data on PAP therapy.