CPAP therapy may protect the heart in some sleep apnea patients but raise risks in others, new research shows.
In a major analysis published in the European Heart Journal, researchers found that CPAP — a standard treatment for obstructive sleep apnea (OSA) — cut the risk of cardiovascular complications like heart attack and stroke in people with high-risk OSA, but surprisingly increased the risk in patients without these high-risk features.
The study combined data from over 3,500 patients across three previous clinical trials, following them for three years. Results showed a 17% drop in cardiovascular risk for high-risk patients but a 22% increase for others.
Lead author Dr. Ali Azarbarzin explained that CPAP appears to help those with severe drops in blood oxygen and major heart-rate spikes during sleep. However, in patients without these markers, the therapy may disturb sleep or strain the heart, leading to negative outcomes.
“These results suggest CPAP should not be prescribed universally for OSA, but instead targeted to patients most likely to benefit,” Azarbarzin said. “A personalized approach is needed.”
Editorial authors noted the study is the first to show possible harm from CPAP in low-risk patients, underscoring the urgency of rethinking treatment guidelines.
