What is the evidence of benefit on cardiovascular events associated with CPAP for obstructive sleep apnea in patients with cardiovascular disease?
In a randomized controlled trial (RCT) of greater than 2700 patients with sleep apnea and cardiovascular disease, the use of CPAP plus usual care compared with usual care alone showed no evidence of benefit on cardiovascular events at a mean follow-up of 3.7 years. However, in patients with atrial fibrillation (AF) (a frequent comorbidity noted with HF), the use of CPAP for obstructive sleep apnea was found to be helpful. Improvements in sleep quality were noteworthy and represented the primary indication for initiating CPAP treatment.