Impact of untreated sleep apnea on mortality: An analysis of patients without CPAP therapy

Abstract

Introduction: Obstructive sleep apnea (OSA) is a prevalent condition associated with a significant increase in overall and cardiovascular mortality, especially in untreated patients with continuous positive airway pressure (CPAP). This study systematically reviewed the literature to assess the impacts of untreated OSA on mortality and the benefits of CPAP treatment. Methods: A systematic review and meta-analysis was conducted. Observational studies, randomized controlled trials, and prospective and retrospective cohorts investigating mortality in OSA patients not treated with CPAP were included. The PubMed, Scopus, and Web of Science databases were searched using specific terms related to OSA, CPAP, mortality, and cardiovascular complications. Results: We included 16 studies covering more than 10,000 patients. The meta-analysis revealed a pooled hazard ratio (HR) for overall mortality of 1.78 (95% CI: 1.50-2.10) and for cardiovascular mortality of 2.34 (95% CI: 1.90-2.88) in OSA patients not treated with CPAP. Significant reductions in cardiovascular and overall mortality are noted with the use of CPAP. Additional benefits included improvements in blood pressure, cognitive function, mental health, and sleep quality. Conclusion: The findings highlight the crucial importance of CPAP treatment to reduce overall and cardiovascular mortality in patients with OSA. Adherence to treatment should be encouraged through strategies of continuous support and patient education. Complementary interventions, such as weight loss and management of comorbidities, are essential to optimize health outcomes. CPAP therapy should be integrated as a central component in the management of obstructive sleep apnea.