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Background <p>Obstructive sleep apnea (OSA) is a prevalent disorder and linked to significant comorbidities such as hypertension, cardiovascular disease, and metabolic syndrome, with continuous positive airway pressure (CPAP) therapy as the first-line treatment. This nationwide study examined demographic and comorbid characteristics of patients with OSA and evaluated the association between CPAP dispensing and changes in cardiometabolic markers and medication use in routine clinical practice.</p> Methods <p>This retrospective cohort study used data from a national health database on patients diagnosed with OSA between 2002 and 2019. Patients were compared by CPAP dispensing status and by the CPAP dispensing index date, both before and after it, among CPAP-dispensed patients. Data analysis included descriptive statistics, t-tests, and chi-square tests.</p> Results <p>Among 20,854 patients with OSA, 10,977 (52.6%) underwent sleep laboratory testing, and 4,110 (37.4%) had CPAP dispensing. Patients with CPAP dispensing were older (61.9 ± 14.0 vs. 59.8 ± 15.3&#xa0;years, <i>p</i> &lt; 0.001) and had higher baseline rates of hypertension (80.6% vs. 75.2%, <i>p</i> &lt; 0.001), cardiovascular disease (48.0% vs. 44.6%, <i>p</i> &lt; 0.001) and atrial fibrillation (30.7% vs 27.2%, <i>p</i> &lt; 0.001) than those without CPAP dispensing. In the CPAP-dispensed group, we observed modest but statistically significant improvements between the pre- and post-dispensing periods in glucose (− 8.2&#xa0;mg/dL, <i>p</i> &lt; 0.01), HbA1c (− 0.1%, <i>p</i> &lt; 0.01), total cholesterol (− 4.0&#xa0;mg/dL, <i>p</i> &lt; 0.01), LDL cholesterol (− 6.7&#xa0;mg/dL, <i>p</i> &lt; 0.01), and triglycerides (− 10.4&#xa0;mg/dL, <i>p</i> &lt; 0.01), alongside an increase in HDL cholesterol.</p> Conclusions <p>In this nationwide real-world cohort, CPAP dispensing was associated with statistically significant, albeit modest, improvements in metabolic markers and a reduction in antihypertensive medication use. Because OSA severity and adherence data were unavailable, these observational findings cannot be attributed solely to CPAP therapy and require confirmation in future studies.</p> Clinical Trial Registration <p>Not applicable – retrospective observational study, not a clinical trial.</p>

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CPAP and cardiometabolic markers in obstructive sleep apnea: a nationwide retrospective cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月5日

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  • Nir Tsur,
  • Nofar Edri,
  • Dean Dudkiewicz,
  • Yehonatan Reuven,
  • Shir Kushnir Bsc,
  • Uri Alkan,
  • Gideon Bachar

摘要

Background

Obstructive sleep apnea (OSA) is a prevalent disorder and linked to significant comorbidities such as hypertension, cardiovascular disease, and metabolic syndrome, with continuous positive airway pressure (CPAP) therapy as the first-line treatment. This nationwide study examined demographic and comorbid characteristics of patients with OSA and evaluated the association between CPAP dispensing and changes in cardiometabolic markers and medication use in routine clinical practice.

Methods

This retrospective cohort study used data from a national health database on patients diagnosed with OSA between 2002 and 2019. Patients were compared by CPAP dispensing status and by the CPAP dispensing index date, both before and after it, among CPAP-dispensed patients. Data analysis included descriptive statistics, t-tests, and chi-square tests.

Results

Among 20,854 patients with OSA, 10,977 (52.6%) underwent sleep laboratory testing, and 4,110 (37.4%) had CPAP dispensing. Patients with CPAP dispensing were older (61.9 ± 14.0 vs. 59.8 ± 15.3 years, p < 0.001) and had higher baseline rates of hypertension (80.6% vs. 75.2%, p < 0.001), cardiovascular disease (48.0% vs. 44.6%, p < 0.001) and atrial fibrillation (30.7% vs 27.2%, p < 0.001) than those without CPAP dispensing. In the CPAP-dispensed group, we observed modest but statistically significant improvements between the pre- and post-dispensing periods in glucose (− 8.2 mg/dL, p < 0.01), HbA1c (− 0.1%, p < 0.01), total cholesterol (− 4.0 mg/dL, p < 0.01), LDL cholesterol (− 6.7 mg/dL, p < 0.01), and triglycerides (− 10.4 mg/dL, p < 0.01), alongside an increase in HDL cholesterol.

Conclusions

In this nationwide real-world cohort, CPAP dispensing was associated with statistically significant, albeit modest, improvements in metabolic markers and a reduction in antihypertensive medication use. Because OSA severity and adherence data were unavailable, these observational findings cannot be attributed solely to CPAP therapy and require confirmation in future studies.

Clinical Trial Registration

Not applicable – retrospective observational study, not a clinical trial.