OSA is associated with significant cardiovascular morbidity. CPAP helps in improving quality of life. Most studies report improvement in sleep-related respiratory events, daytime sleepiness, blood pressure control, and intermediate cardiovascular endpoints, none has unequivocally shown benefits in the reduction of cardiovascular events (eg, cardiovascular mortality, acute myocardial infarction, stroke) as a whole.
As examples: The Sleep Apnea Cardiovascular Endpoints (SAVE) study is one of the largest multicenter randomized clinical trials to examine the impact of CPAP on cardiovascular outcomes. Although the rate of cardiovascular events was slightly improved in that adherent to CPAP (ie, ≥4 hours per night), the benefit was not statistically significant. However, several aspects limited interpretability and generalizability including the exclusion of patients with "sleepy" OSA,…
