CPAP versus Oxygen in Obstructive Sleep Apnea (2024)

Gottlieb, D. J., Punjabi, N. M., Mehra, R., Patel, S. R., Quan, S. F., Babineau, D. C., Tracy, R. P., Rueschman, M., Blumenthal, R. S., Lewis, E. F., Bhatt, D. L., & Redline, S. (2014). CPAP versus Oxygen in Obstructive Sleep Apnea. New England Journal of Medicine, 370(24), 2276-2285. https://doi.org/10.1056/NEJMoa1306766

Gottlieb, Daniel J. ; Punjabi, Naresh M. ; Mehra, Reena et al. / CPAP versus Oxygen in Obstructive Sleep Apnea. In: New England Journal of Medicine. 2014 ; Vol. 370, No. 24. pp. 2276-2285.

@article{f95fc12f861f4ea1a706ba721bdf9cd3,

title = "CPAP versus Oxygen in Obstructive Sleep Apnea",

abstract = "BACKGROUND: Obstructive sleep apnea is associated with hypertension, inflammation, and increased cardiovascular risk. Continuous positive airway pressure (CPAP) reduces blood pressure, but adherence is often suboptimal, and the benefit beyond management of conventional risk factors is uncertain. Since intermittent hypoxemia may underlie cardiovascular sequelae of sleep apnea, we evaluated the effects of nocturnal supplemental oxygen and CPAP on markers of cardiovascular risk. METHODS: We conducted a randomized, controlled trial in which patients with cardiovascular disease or multiple cardiovascular risk factors were recruited from cardiology practices. Patients were screened for obstructive sleep apnea with the use of the Berlin questionnaire, and home sleep testing was used to establish the diagnosis. Participants with an apnea-hypopnea index of 15 to 50 events per hour were randomly assigned to receive education on sleep hygiene and healthy lifestyle alone (the control group) or, in addition to education, either CPAP or nocturnal supplemental oxygen. Cardiovascular risk was assessed at baseline and after 12 weeks of the study treatment. The primary outcome was 24-hour mean arterial pressure. RESULTS: Of 318 patients who underwent randomization, 281 (88%) could be evaluated for ambulatory blood pressure at both baseline and follow-up. On average, the 24-hour mean arterial pressure at 12 weeks was lower in the group receiving CPAP than in the control group (-2.4 mm Hg; 95% confidence interval [CI], -4.7 to -0.1; P = 0.04) or the group receiving supplemental oxygen (-2.8 mm Hg; 95% CI, -5.1 to -0.5; P = 0.02). There was no significant difference in the 24-hour mean arterial pressure between the control group and the group receiving oxygen. A sensitivity analysis performed with the use of multiple imputation approaches to assess the effect of missing data did not change the results of the primary analysis. CONCLUSIONS: In patients with cardiovascular disease or multiple cardiovascular risk factors, the treatment of obstructive sleep apnea with CPAP, but not nocturnal supplemental oxygen, resulted in a significant reduction in blood pressure.",

author = "Gottlieb, {Daniel J.} and Punjabi, {Naresh M.} and Reena Mehra and Patel, {Sanjay R.} and Quan, {Stuart F.} and Babineau, {Denise C.} and Tracy, {Russell P.} and Michael Rueschman and Blumenthal, {Roger S.} and Lewis, {Eldrin F.} and Bhatt, {Deepak L.} and Susan Redline",

year = "2014",

doi = "10.1056/NEJMoa1306766",

language = "English",

volume = "370",

pages = "2276--2285",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachussetts Medical Society",

number = "24",

}

Gottlieb, DJ, Punjabi, NM, Mehra, R, Patel, SR, Quan, SF, Babineau, DC, Tracy, RP, Rueschman, M, Blumenthal, RS, Lewis, EF, Bhatt, DL & Redline, S 2014, 'CPAP versus Oxygen in Obstructive Sleep Apnea', New England Journal of Medicine, vol. 370, no. 24, pp. 2276-2285. https://doi.org/10.1056/NEJMoa1306766

CPAP versus Oxygen in Obstructive Sleep Apnea. / Gottlieb, Daniel J.; Punjabi, Naresh M.; Mehra, Reena et al.
In: New England Journal of Medicine, Vol. 370, No. 24, 2014, p. 2276-2285.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - CPAP versus Oxygen in Obstructive Sleep Apnea

AU - Gottlieb, Daniel J.

AU - Punjabi, Naresh M.

AU - Mehra, Reena

AU - Patel, Sanjay R.

AU - Quan, Stuart F.

AU - Babineau, Denise C.

AU - Tracy, Russell P.

AU - Rueschman, Michael

AU - Blumenthal, Roger S.

AU - Lewis, Eldrin F.

AU - Bhatt, Deepak L.

AU - Redline, Susan

PY - 2014

Y1 - 2014

N2 - BACKGROUND: Obstructive sleep apnea is associated with hypertension, inflammation, and increased cardiovascular risk. Continuous positive airway pressure (CPAP) reduces blood pressure, but adherence is often suboptimal, and the benefit beyond management of conventional risk factors is uncertain. Since intermittent hypoxemia may underlie cardiovascular sequelae of sleep apnea, we evaluated the effects of nocturnal supplemental oxygen and CPAP on markers of cardiovascular risk. METHODS: We conducted a randomized, controlled trial in which patients with cardiovascular disease or multiple cardiovascular risk factors were recruited from cardiology practices. Patients were screened for obstructive sleep apnea with the use of the Berlin questionnaire, and home sleep testing was used to establish the diagnosis. Participants with an apnea-hypopnea index of 15 to 50 events per hour were randomly assigned to receive education on sleep hygiene and healthy lifestyle alone (the control group) or, in addition to education, either CPAP or nocturnal supplemental oxygen. Cardiovascular risk was assessed at baseline and after 12 weeks of the study treatment. The primary outcome was 24-hour mean arterial pressure. RESULTS: Of 318 patients who underwent randomization, 281 (88%) could be evaluated for ambulatory blood pressure at both baseline and follow-up. On average, the 24-hour mean arterial pressure at 12 weeks was lower in the group receiving CPAP than in the control group (-2.4 mm Hg; 95% confidence interval [CI], -4.7 to -0.1; P = 0.04) or the group receiving supplemental oxygen (-2.8 mm Hg; 95% CI, -5.1 to -0.5; P = 0.02). There was no significant difference in the 24-hour mean arterial pressure between the control group and the group receiving oxygen. A sensitivity analysis performed with the use of multiple imputation approaches to assess the effect of missing data did not change the results of the primary analysis. CONCLUSIONS: In patients with cardiovascular disease or multiple cardiovascular risk factors, the treatment of obstructive sleep apnea with CPAP, but not nocturnal supplemental oxygen, resulted in a significant reduction in blood pressure.

AB - BACKGROUND: Obstructive sleep apnea is associated with hypertension, inflammation, and increased cardiovascular risk. Continuous positive airway pressure (CPAP) reduces blood pressure, but adherence is often suboptimal, and the benefit beyond management of conventional risk factors is uncertain. Since intermittent hypoxemia may underlie cardiovascular sequelae of sleep apnea, we evaluated the effects of nocturnal supplemental oxygen and CPAP on markers of cardiovascular risk. METHODS: We conducted a randomized, controlled trial in which patients with cardiovascular disease or multiple cardiovascular risk factors were recruited from cardiology practices. Patients were screened for obstructive sleep apnea with the use of the Berlin questionnaire, and home sleep testing was used to establish the diagnosis. Participants with an apnea-hypopnea index of 15 to 50 events per hour were randomly assigned to receive education on sleep hygiene and healthy lifestyle alone (the control group) or, in addition to education, either CPAP or nocturnal supplemental oxygen. Cardiovascular risk was assessed at baseline and after 12 weeks of the study treatment. The primary outcome was 24-hour mean arterial pressure. RESULTS: Of 318 patients who underwent randomization, 281 (88%) could be evaluated for ambulatory blood pressure at both baseline and follow-up. On average, the 24-hour mean arterial pressure at 12 weeks was lower in the group receiving CPAP than in the control group (-2.4 mm Hg; 95% confidence interval [CI], -4.7 to -0.1; P = 0.04) or the group receiving supplemental oxygen (-2.8 mm Hg; 95% CI, -5.1 to -0.5; P = 0.02). There was no significant difference in the 24-hour mean arterial pressure between the control group and the group receiving oxygen. A sensitivity analysis performed with the use of multiple imputation approaches to assess the effect of missing data did not change the results of the primary analysis. CONCLUSIONS: In patients with cardiovascular disease or multiple cardiovascular risk factors, the treatment of obstructive sleep apnea with CPAP, but not nocturnal supplemental oxygen, resulted in a significant reduction in blood pressure.

UR - http://www.scopus.com/inward/record.url?scp=84902215832&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa1306766

DO - 10.1056/NEJMoa1306766

M3 - Article

C2 - 24918372

AN - SCOPUS:84902215832

SN - 0028-4793

VL - 370

SP - 2276

EP - 2285

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 24

ER -

Gottlieb DJ, Punjabi NM, Mehra R, Patel SR, Quan SF, Babineau DC et al. CPAP versus Oxygen in Obstructive Sleep Apnea. New England Journal of Medicine. 2014;370(24):2276-2285. doi: 10.1056/NEJMoa1306766