• Obstructive Sleep apnea (OSA) is common – 1 in 15 adults has moderate to severe OSA
  • Only 15% of people with moderate to severe sleep apnea are currently recognised or treated
  • Moderate to severe OSA carries a significantly increased risk of premature death from cardiovascular disease (33% mortality at 15 years)
  • Effective treatment with Continuous Positive Air Pressure (CPAP) can eliminate this risk
  • Obstructive Sleep apnea (OSA) is a common problem with a prevalence of one in five adults. One in 15 adults has moderate to severe OSA. Two recent population studies, one in Busselton Western Australia, and the other from Wisconsin, USA, have shown a significant association between untreated moderate to severe OSA and mortality. There was a significant increased risk of death over a 15 to 18 year follow up period, with about a 33% increased risk of death in untreated patients with moderate to severe OSA. The risk of death was significantly reduced by use of Continuous Positive Air Pressure (CPAP) therapy.
  • This data confirms previous clinic based studies. Two widely quoted studies from 2005 showed a significant increased risk of cardiovascular mortality and stroke in patients with untreated severe sleep apnea. This increased risk of death was independent of confounders such as obesity, hypertension and type 2 diabetes. The increased risk was observed independent of the patient’s complaint of daytime sleepiness. Previous studies in patients with hypertensive or coronary artery disease have shown that severe sleep apnea may be present in the absence of daytime symptoms. This has led to the suggestion that such patients should be screened for the possibility of sleep apnea. This is particularly relevant as CPAP significantly reduces the risk of death. This protective effect of CPAP has been borne out by both the clinic studies and now by the Wisconsin paper. This is all the more important given that less than 15% of people with moderate to severe sleep apnea are currently diagnosed or treated with CPAP or BiPAP therapies.
  • The CRS recommended approach is to ask patients with a history of hypertension, atrial fibrillation or cardiovascular disease about snoring or witnessed apnea. Where these conditions are present, a comprehensive home based sleep study or comprehensive laboratory based study may be indicated. If there is moderate or severe sleep apnea with or without symptoms, those patients should be offered a trial of CPAP. CRS also specialises in treating obesity hypoventilation and complex sleep apnea with trials of BiPAP and Servo Controlled Ventilation, respectively.