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CPAP therapy does not decrease carotid IMT in patients with obstructive sleep apnoea

05 Sep 2017

Continuous positive airway pressure (CPAP) does not significantly improve carotid intima-media thickness (IMT) in patients with obstructive sleep apnoea (OSA), according to a new meta-analysis.

“However, carotid IMT was significantly decreased after CPAP treatment in more severe OSA patients and patients with longer CPAP usage,” said researchers.

Pooled data from seven studies, corresponding to 167 cases, showed that there was no significant difference in IMT in OSA patients before and after CPAP (weighted mean difference [WMD], 0.052; 95 percent CI, -0.002 to 0.105; p=0.057). There was significant heterogeneity among studies (p=0.033).

Similarly, a meta-analysis of two included randomized controlled trials (RCTs) showed that CPAP treatment did not significantly change IMT compared with controls (WMD, 0.002; -0.125 to 0.129; p=0.976). No significant publication bias existed among the studies, according to Begg’s and Egger’s tests.

Subgroup analysis showed that those with severe OSA experienced significantly reduced IMT after CPAP treatment (WMD, 0.073; 0.022 to 0.124; p=0.021). Those who received CPAP therapy for at least 6 months also had significantly improved IMT (WMD, 0.121; 0.019 to 0.223; p=0.021).

The meta-analysis involved English articles that measured IMT by ultrasound in adult OSA patients who were receiving CPAP. Case reports, editorials, letters, review articles and animal studies were excluded. Information extracted from the studies included experimental design, CPAP duration, IMT measurements and sample characteristics.

Of the seven eligible studies, two were RCTs while the remaining five were observational studies. Two observational studies did not report the gender distribution in the sample while one did not detail carotid IMT thickness measurement.

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Most Read Articles
Pearl Toh, 4 days ago
A study finds no evidence that using pharmaceutical aids alone for smoking cessation helps improve the chances of successful quitting despite promising results in previous randomized trials and routine prescription of such drugs to help quit smoking.
Audrey Abella, 22 May 2017
Fixed-dose combinations of long-acting β2-agonist (LABA) and muscarinic antagonist (LAMA) offered superior efficacy and comparable safety to LAMA or LABA/inhaled corticosteroid (ICS), the two most commonly prescribed first-line treatments for stable moderate-to-very-severe chronic obstructive pulmonary disease (COPD), according to a meta-analysis.
Stephen Padilla, 09 Jan 2018
Very elderly adults have the highest rate of invasive pneumococcal diseases, according to a recent study, suggesting that age influences manifestations of this illness.
02 Sep 2017
Early Lactobacillus rhamnosus GG (LGG) supplementation does not appear to be effective in the prevention of eczema or asthma development at 2 years of age in high-risk infants, according to a study.