Sleep Apnea patients not using CPAP at higher risk of heart failure

"It is indisputable in a study with this many patients that sleep apnea patients as a group do in fact develop more heart failure than the general public, although the observational study design makes it hard to determine a cause-and-effect relationship," said the study's lead author, Dr. Anders Holt.

"This should encourage doctors caring for sleep apnea patients to pay extra attention to monitoring and treating other cardiovascular risk factors, as well as the sleep apnea," said Holt, a researcher with the Department of Cardiology at Copenhagen University in Denmark.

Dr. Donna Arnett, dean and professor of epidemiology at the College of Public Health at the University of Kentucky, said the study "shows that the use of CPAP can be protective against incidence of heart failure."

Arnett, who was not part of the study, said "we need to educate physicians about the importance of sleep apnea, which is an incredibly under-recognized disorder, and we need to encourage patients to be screened."The research underscores the importance of helping patients learn to adjust to sleeping with CPAP masks.

"CPAP can be an uncomfortable treatment," Arnett said. "Sleeping with a mask over your face can cause nasal dryness and facial irritation. But people do adapt to it. They do get used to it. It's important for patients to understand that, and to work with their healthcare provider to find the right mask and device that works best for them."

Holt further said that the study certainly bolstered confidence in CPAP's effectiveness – especially in light of a 2015 sleep apnea paper in the New England Journal of Medicine that found higher risks of death for certain heart failure patients who used adaptive servo-ventilation, called ASV. It's a machine similar to a CPAP but it treats central sleep apnea, a less common condition in which the brain doesn't send regular signals to the diaphragm to contract and expand.

The new research, Holt said, sends a "clear, reassuring signal" about the benefits of CPAP therapy for patients with heart failure. CPAP may improve not only hypertension but also arterial stiffness, and lead to improvements in the prognosis of patients with heart failure with preserved ejection fraction

For further information log on to :

Anders Holt et al. Sleep Apnea, the Risk of Developing Heart Failure, and Potential Benefits of Continuous Positive Airway Pressure (CPAP) Therapy, Journal of the American Heart Association (2018). DOI: 10.1161/JAHA.118.008684