@article{de66d8848a0949cab1c3640e7ed10f2a,
title = "Long-term positive airway pressure therapy is associated with reduced total cholesterol levels in patients with obstructive sleep apnea: data from the European Sleep Apnea Database (ESADA)",
abstract = "Background and aim: Obstructive sleep apnea (OSA) is an independent risk factor for dyslipidemia. The current study examined the effects of positive airway pressure (PAP) treatment on lipid status in the European Sleep Apnea Database (ESADA). Methods: The prospective cohort study enrolled 1564 OSA subjects (74% male, mean age 54 ± 11y, body mass index (BMI) 32.7 ± 6.6 kg/m2 and apnea-hypopnea index (AHI) 40.3 ± 24.4 n/h) undergoing PAP therapy for at least three months (mean 377.6 ± 419.5 days). Baseline and follow-up total cholesterol (TC) from nine centers were analyzed. Repeated measures and logistic regression tests (adjusted for age, sex, weight changes, lipid lowering medication, PAP compliance, and treatment duration) were used to compare changes in TC concentration. Incident risk for a coronary heart disease event (CHD) was used to compute a Framingham CHD risk score (estimated from age, BMI, blood pressure, and TC). Results: Adjusted means of TC decreased from 194.2 mg/dl to 189.3 mg/dl during follow-up (p = 0.019). A clinically significant (10%) reduction of TC at PAP follow-up was observed in 422 patients (27%). Duration of PAP therapy was identified as independent predictor for TC reduction, which implies an approximately 10% risk reduction for incident CHD events (from 26.7% to 24.1% in men and from 11.2% to 10.1% in women, p < 0.001 respectively). Conclusion: This observational study demonstrates a reduction of TC after long-term PAP treatment. The close association between TC concentration and cardiovascular (CV) mortality suggests that identification and treatment of OSA may have a beneficial effect on overall CV risk due to this mechanism. This possibility needs to be evaluated in prospective randomized studies.",
keywords = "Cardiovascular risk, Cholesterol, Hypoxia, Positive airway pressure, Sleep apnea",
author = "{the European Sleep Apnea Database collaborators} and Canan Gunduz and Basoglu, {O. K.} and Kvamme, {J. A.} and J. Verbraecken and Ulla Anttalainen and Oreste Marrone and P. Steiropoulos and Gabriel Roisman and P. Joppa and Holger Hein and G. Trakada and J. Hedner and L. Grote and P. Steiropoulos and J. Verbraecken and E. Petiet and G. Trakada and Montserrat, {J. M.} and I. Fietze and T. Penzel and L. Ondrej and D. Rodenstein and Masa, {J. F.} and I. Bouloukaki and S. Schiza and B. Kent and McNicholas, {W. T.} and S. Ryan and Riha, {R. L.} and Kvamme, {J. A.} and H. Hein and R. Schulz and L. Grote and J. Hedner and D. Zou and P{\'e}pin, {J. L.} and P. Levy and S. Bailly and L. Lavie and P. Lavie and Basoglu, {O. K.} and Tasbakan, {M. S.} and G. Varoneckas and P. Joppa and R. Tkacova and R. Staats and F. Barb{\'e} and C. Lombardi and G. Parati and M. Drummond",
note = "Funding Information: The ESADA network has received support from the European Union COST action B26 and the European Respiratory Society (ERS) funded Clinical Research Collaboration (CRC). Unrestricted seeding grants from the ResMed Foundation and the Philips Respironics Foundation for establishment of the database in 2007 and 2011 are gratefully acknowledged. The ESADA network has a scientific collaboration with Bayer AG. Funding Information: Nonfinancial support was provided by the European Sleep Research Society (ESRS) and the European Respiratory Society (ERS) in terms of logistics for communication, meetings and data presentations for the ESADA collaborators. Funding Information: Dr. Verbraecken reports grants and personal fees from ResMed, Bioprojet, Jazz Pharmaceutics; personal fees from Philips, Sanofi, Agfa-Gevaert, grants from AirLiquide; personal fees from Springer, Westfalen Medical, SomnoMed, Vivisol, Total Care, Medidis, Fisher & Paykel, Wave Medical, OSG, Mediq Tefa, NightBalance, Heinen & L{\"o}wenstein, AstraZen, Accuramed, Bekaert Deslee Academy and UCB Pharma, outside the submitted work. Dr. Hedner reports grants from ResMed, Philips Respironics, and the European Respiratory Society all related to maintenance of database on behalf of the ESADA group during the conduct of the study. Dr. Grote reports grants from Bayer, Resmed, Respironics/Philips, and from the European Respiratory Society during the conduct of the study; non-financial support and other from Itamar Medical, Resmed, Philips, and Astra Zeneca, outside the submitted work. In addition, Dr. Grote has a patent on sleep apnea therapy licensed. The remaining co-authors have no conflict of interest to declare. Publisher Copyright: {\textcopyright} 2020 Elsevier B.V. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = nov,
doi = "10.1016/j.sleep.2020.02.023",
language = "English",
volume = "75",
pages = "201--209",
journal = "Sleep Medicine",
issn = "1389-9457",
publisher = "Elsevier",
}