OSA cardiovascular risk: Statistics?

[finsko]

Does anybody have any numbers  (even better, first hand scientific references)
(even more better, publicly available in pdf format :-) ) for
what the increased likelihood is of cardiovascular problems with untreated OSA
vs similar populations without OSA?  Clearly (from the archives) "Everybody
is different", but I have had no obvious benefit from 7 weeks of pretty consistent
use with a low AHI; if I continue to have no obvious benefit I will need to
dig deeper into the (claimed :-) ) hidden benefits.

Thanks

[Crimson Nape]

While I don't have any data to offer, it took me almost a year to see any benefits. My blood pressure went from uncontrollable down to being in the normal range. That's good enough for me.

[Hydrangea]

I'm curious about scientific evidence as well!

But I'm thrilled to tell you that I've had great improvement!

- When I wake up in the morning, my heart is no longer racing. Surely that has got to be better for my heart health!

- I no longer feel heart palpitations. (I used to have thousands a day, and I could feel maybe 10 of them. I don't know how many I have now, but I feel zero.)

- My heart has a consistent rhythm. My smartphone has an app that measures heart rate, and it shows the rhythm as it's happening. Pre-CPAP, it was jagged and not rhythmic (my cardiologist said I had extra heartbeats). But now it looks like a normal and consistent rhythm. (I've not been back to the cardiologist... I've only seen this on the app on my phone.)

[SideSleeper]

I wish I could report Hydrangea's experience! I have sub ventricular tachycardia and CPAP use for 2.5 years, 100% compliance, current 6 mo. AHI 0.53--no decrease in frequency of the problem. Only difference I have found is I no longer have Gerd/heartburn--was on prescription Rx before CPAP. My blood pressure has remained the same.

[Timur]

Does anybody have any numbers  (even better, first hand scientific references)
(even more better, publicly available in pdf format :-) ) for
what the increased likelihood is of cardiovascular problems with untreated OSA
vs similar populations without OSA? 

Here's a study that might fit the bill?

"Coronary heart disease incidence in Sleep Disordered Breathing : The Wisconsin Sleep Cohort Study" 

https://academic.oup.com/sleep/article/38/5/677/2416871

[Timur]

I can't seem to edit my previous post but just want to add that the study I cited used 4% desaturations and not 3% for their definition of hypopnea.

The PSGs on this cohort were originally done in 1988 and since then a lot has changed in identifying SDB.

Participants were followed for 24 years.

Unfortunately long term studies using the current AASM recommended definition for hypopnea simply aren't available.

[finsko]

Timur: Excellent! It seems to be exactly what I was looking for (including a breakdown into different AHI levels), and it even includes a download PDF option. Thanks!

finsko

[Timur]

Finsko, glad to be of help.

I have to admit I have a few reservations about that particular study, but then again most studies I read about OSA leave me feeling very frustrated.

My biggest issue is that over time the criteria and definition for what constitutes an hypopnea have changed and this has resulted in more people being diagnosed with OSA and SDB than back in 1988. I believe that this accounts quite a lot for the  "epidemic" in recent years  in the prevalence of OSA and SDB. 

Yet no changes have been made in what is considered mild, moderate and severe OSA.

So an AHI of say 4 using the 4% desaturation criterion could now be an AHI of say 18 using the newer AASM 2012 definition. (If I am interpreting this incorrectly please anyone feel free to correct me!)

These changes are  almost never addressed in longitudinal studies that are still using the older criteria.  

Anyway, here's a commentary that was published discussing this study and it raises some interesting questions about using an AHI of zero for the reference group (which largely  comprised  very healthy, most likely pre menopausal women.) rather than the standard use of a group with an AHI of less than or equal to 5. 

So, did this skew the results (for women especially),  and also for the entire cohort? 

https://academic.oup.com/sleep/article/38/5/659/2416838

[finsko]

Timur: I haven't read the paper(s)  yet (I've printed them out), but the criticism you make (AHI of zero in the control group) would seem to make the study's reported number (roughly double risk for untreated OSA)  actually *higher* than the "real" number. Which is good news to me, because  I'd like for that number to be as low as possible :-). (To tell the truth, I anticipated the CV risk being much higher than 2, given the emphasis my doc put on it).

Thanks again!