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(Reuters Health) – A recent study suggests that obese people with sleep apnea, a common nocturnal breathing disorder, may live longer when they use a machine to keep their airways open during their sleep.
After following obese patients with sleep apnea for approximately 11 years, the researchers found that those who used the night breathing aid were 42% less likely than those who did not use devices to die of whatever cause.
Improperly treated apnea has been badociated with excessive daytime sleepiness, heart attacks, heart failure and increased risk of premature death. Patients are often instructed to treat with masks attached to a machine providing continuous positive airway pressure (CPAP), which allows the airway to be attached by opening them with a continuous stream of air so that the airways can not collapse during sleep. Some patients receive positive airway pressure (PAP) devices that alter the amount of atmospheric pressure for inspiration and exhalation instead of keeping it constant.
"In patients with sleep apnea, there is low oxygenation of the body during sleep," said Dr. Quentin Lisan, lead author of the study, Center for Cardiovascular Research in Paris. La France.
"This has several consequences, including an increased risk of cardiovascular disease," Lisan said by e-mail. "PAP therapy allows for better oxygenation of the body during sleep, thus reducing the risk of these badociated conditions, which could reduce mortality."
For the present study, researchers looked at data from 81 obese patients with sleep apnea who had been prescribed PAP treatment and from a control group of 311 patients with apnea and nausea. Having not received this type of treatment.
After an average follow-up period of about 11 years, 12 patients who were prescribed a PAP died, as well as 84 people who were not prescribed to a PAP, the Lisan team reports that the operation JAMA Otolaryngology – Head & Neck.
All patients in the study had severe apnea and the results may be different for people with less severe forms of nocturnal breathing disorder, Lisan noted.
One of the disadvantages of PAP devices is that they can be noisy and uncomfortable, and sometimes make patients difficult to fall or stay asleep.
Some patients who do not tolerate the wearing of the respiratory mask all night can use an alternative apnea treatment called mandibular advancement devices, which release space in the airways by pushing back the airway. 39, the lower jaw bone to reduce the risk of collapse of the upper airway. to sleep.
The study was not designed to prove that PAP machines could help apnea patients live longer. He also did not test the chances of survival with the PAP against people who used alternative apnea interventions.
One of the limitations of the results is that it is not known how consistently PAP patients have used the devices as prescribed, which may affect the effectiveness of the treatment.
"Patients must adhere to PAP for the treatment to work, and we know from other studies that the more they enroll in the device, the more they will have an illness," said Dr. Clete Kushida, author of a comment that accompanied him. Stanford Sleep Medicine Center in Redwood City, California.
"We do not know exactly why PAPs reduce the risk of death, but PAPs may have reduced mortality from factors such as heart attacks, strokes, high blood sugar and high blood pressure," Kushida said by e-mail.
When patients do not tolerate PAP, they should talk to their doctor to see if the settings can be adjusted to make it more comfortable, said Marie-Pierre St-Onge, Sleeping Researcher at Irving University's Columbia Medical Center. New York. not involved in the study. They can do better with different pressure settings or with another PAP machine.
"Some people need more or less pressure to keep the airways open and a sleep test in the lab can help us determine the optimal pressure," St-Onge said by email. "Too high is uncomfortable, too low will not be effective."
SOURCE: bit.ly/2KOTnBs and bit.ly/2vcvBok JAMA Otolaryngology-Head & Neck Surgery, online April 11, 2019.
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