Sleep apnea ‘mask' might also help the heart - AL2o3 Ceramic - China Metal Ceramic Tube

The results were published in a pair of studies in the May 23/30issue of the Journal of the American Medical Association . Both studies found that people who used CPAP, the most commontreatment for sleep apnea, for at least four hours a night hadlower rates of developing high blood pressure compared with thosewho were not prescribed CPAP or who used it less regularly. "CPAP seems to have a protective effect in patients who use themachine properly," said Dr. José Marin, director of theSleep Respiratory Unit at Miguel Servet University Hospital inZaragoza, an author of both studies. However, about 10 percent of people used the machine for fewer thanfour hours nightly, which is considered the minimum amount to seebenefits, Marin said.

Many patients are uncomfortable with CPAP because it isinconvenient and the mask covers their nose while they sleep, orthe person they sleep with does not like the noise the machinemakes, Marin said. But alternative treatments, such as surgery or mouth devices,generally don't work as well as CPAP, and there are less datasuggesting they reduce the risk of high blood pressure, said Dr.Aneesa Das, assistant director of the sleep disorders program atthe Ohio State University Wexner Medical Center. A reduction in high blood pressure risk could also reduce the riskof other diseases, such as heart failure, which are more common inpeople with sleep apnea. "The idea is that there are probablymultiple factors that are causing cardiovascular events and stroke[in sleep apnea patients], including [high blood pressure]," saidDas.

It is estimated that 17 percent of U.S. adults have obstructivesleep apnea, which occurs when the airway closes during sleep andrestricts breathing. It can cause people to wake up repeatedly andcan lead to low levels of oxygen in the blood. One of the studies included about 1,900 patients at Marin's sleepclinic who did not have high blood pressure. Their average age was50.

The researchers assigned participants to CPAP treatment if they hadsevere obstructive sleep apnea or a less severe form along withdaytime sleepiness. Then they measured their blood pressure eachyear for an average of 11 years. The investigators found that patients with sleep apnea who usedCPAP therapy were 29 percent less likely to develop high bloodpressure during the study than the "control" group, which did nothave sleep apnea and did not receive CPAP. However, as Marinpointed out, the people in the control group were "snorers, andthey have been reported to have cardiovascular problems." The researchers also found that patients with sleep apnea who didnot use CPAP had higher rates of high blood pressure compared withthe control group. For example, the 10 percent of 922 participants who did not useCPAP at least four hours a night had a 78 percent higher risk ofdeveloping high blood pressure than the control group.

The researchers found that the lower risk of high blood pressure inthe CPAP group could not be explained by differences in factorssuch as patients' body mass index (a measurement that takes intoaccount height and weight), alcohol use or blood pressure at thebeginning of the study. However, there could still be differences between the CPAP-treatedand untreated groups that could make the CPAP group less likely todevelop high blood pressure, Marin said. Marin and his colleagues conducted a second study in which theyrandomly assigned 725 patients who had obstructive sleep apnea butnot daytime sleepiness to use CPAP or not to use CPAP. Then theytracked participants' blood pressure and heart disease for anaverage of four years.

At first the researchers did not see a statistically significantdifference between the groups. However, 36 percent of the CPAPgroup was using the machine less than four hours a night. In a follow-up analysis, which the authors pointed out may be opento bias, the researchers found that patients using CPAP for atleast four hours a night were 28 percent less likely than thecontrol group to develop high blood pressure. Dr.

Stuart Quan, professor of sleep medicine at Harvard MedicalSchool in Boston, wasn't surprised by the findings. "I alreadybelieve that sleep apnea impacts [high blood pressure] and treatingwith CPAP reduces the risk, so these studies do not affect my wayof thinking about this," he said. Quan added that he prescribes CPAP to patients with at leastmoderate obstructive sleep apnea or those with sleep apnea andsymptoms such as daytime sleepiness or mood problems. Medicare requires patients to use CPAP at least four hours a nightfor 70 percent of nights to cover the treatment.

The insurancedeductible for CPAP is usually between $100 and $500, Quan said. While the study uncovered an association between CPAP use andreduced risk of developing high blood pressure, it did not prove acause-and-effect relationship. More information To learn more about sleep apnea, visit the U.S. National Heart, Lung, and Blood Institute . SOURCES: José Marin, M.D., director, Sleep Respiratory Unit,Miguel Servet University Hospital, and professor, University ofZaragoza, Zaragoza, Spain; Aneesa Das, M.D., assistant director,Ohio State sleep disorders program, and assistant professor,pulmonology, allergy, critical care, sleep, Wexner Medical Centerat Ohio State University, Columbus, Ohio; Stuart F.

Quan, M.D.,professor, sleep medicine, Harvard Medical School, Boston; May23/30, 2012, Journal of the American Medical Association Copyright © 2012 HealthDay . All rights reserved.

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