TY - JOUR

T1 - Sleep apnea, the risk of out-of-hospital cardiac arrest, and potential benefits of continuous positive airway pressure therapy

T2 - A nationwide study

AU - Qayoumi, Pelpika

AU - Coronel, Ruben

AU - Folke, Fredrik

AU - Arulmurugananthavadivel, Anojhaan

AU - Parveen, Saaima

AU - Yonis, Harman

AU - Meaidi, Amani

AU - Lamberts, Morten

AU - Schou, Morten

AU - Torp-Pedersen, Christian

AU - Hilmar Gislason, Gunnar

AU - Eroglu, Talip E.

N1 - Publisher Copyright: © 2024 The Author(s)

PY - 2024

Y1 - 2024

N2 - Objective: Patients with sleep apnea (SA) are at increased cardiovascular risk. However, little is known about the risk of out-of-hospital cardiac arrest (OHCA) in patients with SA. Therefore, we studied the relation between SA patients who did and did not receive continuous positive airway pressure (CPAP) therapy with OHCA in the general population. Methods: Using nationwide databases, we conducted a nested case-control study with OHCA-cases of presumed cardiac causes and age/sex/OHCA-date matched non-OHCA-controls from the general population. Conditional logistic regression models with adjustments for well-known OHCA risk factors were performed to generate odds ratio (OR) of OHCA comparing patients with SA receiving and not receiving CPAP therapy with individuals without SA. Results: We identified 46,578 OHCA-cases and 232,890 matched non-OHCA-controls [mean: 71 years, 68.8% men]. Compared to subjects without SA, having SA without CPAP therapy was associated with increased odds of OHCA after controlling for relevant confounders (OR:1.20, 95%-Cl:1.06–1.36), while having SA with CPAP therapy was not associated with OHCA (OR:1.04, 95%-Cl:0.93–1.36). Regardless of CPAP therapy, age and sex did not significantly influence our findings. Our findings were confirmed in: (I) patients with neither ischemic heart disease nor heart failure (untreated SA, OR:1.24, 95%-CI:1.04–1.47; SA with CPAP, OR:1.08, 95%-CI:0.93–1.25); and (II) in patients without cardiovascular disease (untreated SA, OR:1.33, 95%-CI:1.07–1.65; SA with CPAP, OR:1.14, 95%-CI:0.94–1.39). Conclusion: SA not treated with CPAP was associated with OHCA, while no increased risk of OHCA was found for SA patients treated with CPAP.

AB - Objective: Patients with sleep apnea (SA) are at increased cardiovascular risk. However, little is known about the risk of out-of-hospital cardiac arrest (OHCA) in patients with SA. Therefore, we studied the relation between SA patients who did and did not receive continuous positive airway pressure (CPAP) therapy with OHCA in the general population. Methods: Using nationwide databases, we conducted a nested case-control study with OHCA-cases of presumed cardiac causes and age/sex/OHCA-date matched non-OHCA-controls from the general population. Conditional logistic regression models with adjustments for well-known OHCA risk factors were performed to generate odds ratio (OR) of OHCA comparing patients with SA receiving and not receiving CPAP therapy with individuals without SA. Results: We identified 46,578 OHCA-cases and 232,890 matched non-OHCA-controls [mean: 71 years, 68.8% men]. Compared to subjects without SA, having SA without CPAP therapy was associated with increased odds of OHCA after controlling for relevant confounders (OR:1.20, 95%-Cl:1.06–1.36), while having SA with CPAP therapy was not associated with OHCA (OR:1.04, 95%-Cl:0.93–1.36). Regardless of CPAP therapy, age and sex did not significantly influence our findings. Our findings were confirmed in: (I) patients with neither ischemic heart disease nor heart failure (untreated SA, OR:1.24, 95%-CI:1.04–1.47; SA with CPAP, OR:1.08, 95%-CI:0.93–1.25); and (II) in patients without cardiovascular disease (untreated SA, OR:1.33, 95%-CI:1.07–1.65; SA with CPAP, OR:1.14, 95%-CI:0.94–1.39). Conclusion: SA not treated with CPAP was associated with OHCA, while no increased risk of OHCA was found for SA patients treated with CPAP.

KW - Cardiac electrophysiology

KW - CPAP

KW - Sleep apnea

KW - Sudden cardiac arrest

U2 - 10.1016/j.resuscitation.2024.110174

DO - 10.1016/j.resuscitation.2024.110174

M3 - Journal article

C2 - 38479652

AN - SCOPUS:85188590166

VL - 198

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

M1 - 110174

ER -