Cardiovascular
Sleep Apnea: How CPAP Machines Can Help Lower Heart Disease Risk
Sep
- Sleep apnea may increase the risk of many diseases, including heart disease.
- Two new studies suggest treatment with CPAP can reduce cardiovascular deaths related to sleep apnea and may be superior to weight loss drugs for treating the disorder.
- Barriers to accessing these machines include getting a proper evaluation for sleep apnea, adjusting to the comfort of using CPAP devices, and having sufficient insurance or income to cover their purchase.
Sleep apnea, a disorder in which your breathing is frequently interrupted while you sleep and often characterized by loud snoring, affects as many as 30 million people in the United States, although only 6 million are diagnosed.
The condition can lead to an increased risk of cardiovascular disease, type 2 diabetes, heart attack, and stroke.
Now, a pair of studies presented at the 2023 European Respiratory Society International Congress suggests a possible solution.
Researchers say that using continuous positive airway pressure (CPAP) machine therapy could not only reduce a person’s risk of dying from cardiovascular disease related to sleep apnea but might even be superior to weight loss drugs for treating the disorder.
The findings have not yet been published in a peer-reviewed journal.
How CPAP machines may lower risk of death
In the first study, researchers looked at two groups of adults with obstructive sleep apnea, one that stopped using CPAP machines in 2011 and another that continued to use them until 2015 or until death.
The researchers reported that those who continued to use CPAP treatment nightly had a 40% lower risk of dying by any cause, a 36% lower risk of dying from cardiovascular disease, and an 18% lessened risk of ending up in the hospital with cardiovascular disease than the group that stopped treatment.
CPAP machines push air through the nose via a nasal mask the user wears nightly, preventing the intermittent collapse of the airway that characterizes sleep apnea.
“The findings of the first study are certainly encouraging. It makes sense that increased consistent oxygenation would improve cardiovascular health and decrease mortality,” Dr. Alexandra L. Kharazi, a cardiothoracic surgeon who was not involved in the study, told Healthline.
“However, it’s worth noting that people who chose not to adhere to CPAP may also have chosen not to adhere to other recommended treatments for their health conditions,” Kharazi noted. “This includes medications for high cholesterol, high blood pressure, and diabetes. This could contribute to the likelihood of developing cardiovascular complications, such as heart attack and stroke.”
CPAP machines compared to weight loss drugs
In the second study, researchers studied the efficacy of CPAP machines compared to weight loss drugs, as being overweight or obese is a significant risk factor for sleep apnea.
In that pilot study, researchers reported, the two groups that either used a CPAP machine nightly or used CPAP and took weight loss drugs each experienced reductions in arterial plaque and less inflammation in their aorta compared to a third group of patients that took only weight loss drugs.
While the researchers cautioned that further study was needed, those findings make sense, according to Chelsie Rohrscheib, PhD, a neuroscientist and head sleep expert at sleep technology company Wesper.
“Sleep apnea damages the cardiovascular system in a number of ways,” Rohrscheib told Healthline. “Frequent drops in oxygen caused by sleep apnea are damaging to the brain and body, especially the cardiovascular system. Sleep apnea cause frequent increases in this pressure, which places a direct strain on the heart. Sleep apnea has also been shown to increase systemic oxidative stress, which is harmful to DNA, cells, and tissues.”
“This combination of factors damages your very delicate arteries and blood vessels, and the body attempts to repair this damage with plaque,” she added. “Thus, regardless of weight loss and medications, the assault on the cardiovascular system is very unlikely to improve unless sleep apnea is corrected with treatments like CPAP.”
Access to sleep apnea treatments is an issue
While CPAP machines might be the most promising treatment for preventing apnea-related deaths from cardiovascular diseases — as well as helping people get better sleep — there are some significant barriers to access that prevent more widespread usage of CPAP machines, experts said.
The first is evaluation.
“The main barriers are a lack of access to sleep testing centers, poor or no health care coverage, and lack of assistance when it comes to adjusting to using the CPAP,” Rohrscheib said. “Sleep apnea sufferers may consider home sleep testing and telemedicine.”
The other issue is that many people find CPAP machines uncomfortable. That’s one of the reasons researchers were able to evaluate groups of participants who gave up on using the machines compared to those who kept using them.
However, there are some options.
“A healthcare provider can help a patient find one that works for them,” said Dr. Chester Wu, an expert in sleep medicine and psychiatry. “A patient can also experiment with how they wear the device to find a more comfortable fit.”
“Using a humidifier with a CPAP machine has been shown to increase adherence,” he told Healthline.
If that’s still uncomfortable, there may be other treatment options, including a similar machine called a bilevel positive airway pressure machine, positional therapy, and surgery. However, these could be less effective than CPAP.
Finally, for many Americans, there is the issue of cost.
“They’re expensive, as are accessory components, and many insurance plans don’t cover the full cost,” Wu said. “If this is the case, patients might have access to subsidized or second-hand machines.”
One expert suggested another potential avenue is to reach out to CPAP suppliers directly and discuss options.
As with any health condition, seeking community support can be critical to successful adherence to treatment.
“Patients should consider joining CPAP support groups, which are very helpful during the adjustment period, or speak to a sleep expert online for assistance,” Rohrscheib said.
