Efficacy of continuous positive airway pressure on arrhythmias in obstructive sleep apnea patients

The purpose of this study was to determine the relationship between obstructive sleep apnea (OSA) and cardiovascular disorders in a large Japanese population, and to assess the efficacy of continuous positive airway pressure (CPAP) in the treatment of OSA-associated arrhythmias. The study population comprised 1394 Japanese subjects (1086 men and 308 women) who were divided into four groups on the basis of polysomnography (PSG) analysis as follows: the no sleep apnea (N-SA) group ( n = 44, apnea-hypopnea index [AHI] < 5), the mild OSA (Mi-OSA) group ( n = 197, 5 < AHI < 15), the moderate OSA (Mo) group ( n = 368, 15 < AHI < 30), and severe OSA (SOSA) group ( n = 785, AHI < 30). The following baseline characteristics were significantly associated with OSA: age ( P < 0.001), gender ( P < 0.001), body mass index ( P < 0.001), hypertension ( P < 0.001), diabetes ( P = 0.009), and hyperlipidemia ( P = 0.013). In the OSA group, PSG revealed the predominance of paroxysmal atrial fibrillation (PAF) ( P = 0.051), premature atrial complex short run ( P < 0.005), premature ventricular complex (PVC, P = 0.004), sinus bradycardia ( P = 0.036), and sinus pause (arrest >2 s, P < 0.001) during the PSG recording. A total of 316 patients from the group underwent CPAP titration and were then re-evaluated. Continuous positive airway pressure therapy significantly reduced the occurrences of PAF ( P < 0.001), PVC ( P = 0.016), sinus bradycardia ( P = 0.001), and sinus pause ( P = 0.004). The results of this study demonstrate a significant relationship between OSA and several cardiac disorders, and also demonstrate the efficacy of CPAP in preventing OSA-associated arrhythmias in a large population of Japanese patients.