IMPORTANT New Apnea Study

[neversleeps]

I think neversleeps is right to emphasize the shortcomings in that study. Would have been better to put an "emphasis mine" thingy in the post, but that's a minor quibble in my mind compared to the service neversleeps is doing by bringing out the problem with the way those researchers defined, studied, and drew conclusions about people who received "treatment" for OSA.

Thanks rested gal. It's nice to know you are as impassioned about this subject as I am.


The second post on this thread contained the following sentence:

The Yale study showed that even with treatment sleep apnea still had an elevated risk of stroke and death.

That is what he (and others, as you read the other posts and message boards) found noteworthy. I did not bring this issue to the forefront, in fact, I spent the remainder of the thread trying to undo the damage done by the Yale study authors with that one single sentence: "Nonetheless, our study demonstrated an increased risk of stroke or death from any cause among patients with the obstructive sleep apnea syndrome despite the administration of various therapies."

I hope I succeeded in dispelling the notion that cpap therapy was scientifically determined to have no effect on stroke risk, as the researchers so injudiciously implied.

I could go on until I'm blue in the face (or feet---oops!! too late!), about this study and the now infamous sentence mentioned above (and in previous posts, and in various stages of boldness and sizes of print), but Ozij summed it up well:

"Anyone worried by it should either disregard it, or look for studies done about the effects of CPAP or Automatic PAP (APAP) on people who use it consisntently [sic], all night, and for each nap"

(Emphasis Ozij's.)

[Sleepless on LI]

I just would like to offer an observation as to what a wonderful a group of people this is who have debated this thread in the manner in which it was done, civilized, cordially and impersonally, without allowing it to get out of control and nasty. No, the opinions offered did not have to take the tone they did and I am very impressed at how calmly and rationally everyone remained while expressing their individual views.

I think it's safe to assume that anything needed to be said about it was said, more than once, and you can all be proud of yourselves on how well this discussion was conducted. Very nicely done.

[Jere]

Lori - Is that your nice way to say that we have all beaten this topic to death and we should move on?

[Sleepless on LI]

Lori - Is that your nice way to say that we have all beaten this topic to death and we should move on?

LOL! No. Please, debate on! I just was very impressed, as I said, as to how civilized this entire thread was handled. Good people with good manners.

[Bonnie]

I found this article on a study done in Ireland, reported in a Illinois paper.
It does address the use of cpap

Sleep Therapy May Protect Against Death from Heart Disease

NORTHBROOK, IL -- June 17, 2005 -- A common sleep therapy used to treat patients with obstructive sleep apnea (OSA) may actually have a protective effect against death related to cardiovascular disease.

In a new study published in the June issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians, patients with OSA who were treated with continuous positive airway pressure (CPAP) had significantly fewer cardiovascular disease-related deaths and cardiovascular-related events than untreated patients.

"Research has shown that patients with OSA have an increased incidence of death or events related to cardiovascular disease, particularly hypertension," said Walter McNicholas, MD, FCCP, St. Vincent's University Hospital, Dublin, Ireland. "Short-term use of CPAP therapy has resulted in health and quality-of-life benefits in patients with sleep apnea, including improved daytime alertness and mental functioning. Extended CPAP therapy may have additional benefits for patients with OSA by protecting them against cardiovascular disease related to the sleep disorder."

Researchers from St. Vincent's University Hospital in Dublin followed 168 patients with OSA for an average of 7.5 years to monitor the long-term effect of CPAP therapy on cardiovascular disease.

Researchers compared the number of cardiovascular-related events and deaths between 107 patients who used CPAP therapy and 61 patients who never tolerated or stopped CPAP therapy for at least five years. During the follow-up period, there was a significant excess of cardiovascular deaths among the untreated patients (14.8%), compared to CPAP group (1.9%).

The total number of cardiovascular events, including death, congestive heart failure, hypertension, and stroke, also was significantly greater in the untreated group (31%), compared to the CPAP group (18%). There were no significant differences between the CPAP group and the untreated group in terms of age, body mass index, and cardiovascular risk factors at baseline; however, patients in the untreated group had significantly lower apnea scores and more had undergone nasal surgery prior to diagnosis of OSA.

"The association between OSA and cardiovascular disease is not fully understood. It is possible that the constant fluctuation in blood oxygen levels caused by OSA may contribute to arterial inflammation, blood flow obstruction, and, eventually, increased hypertension and cardiovascular-related events," said Dr. McNicholas. "Through the long-term relief of OSA, patients may decrease the subtle physical effects of OSA, thereby decreasing the overall incidence of cardiovascular morbidity and mortality."

"Sleep apnea is associated with several modifiable risk factors, including obesity, smoking, and excessive alcohol use," said Paul A. Kvale, MD, FCCP, President of the American College of Chest Physicians. "Although it is important to manage OSA through treatments, such as CPAP, physicians and patients must take steps to identify and modify risk factors that may be contributing to the disorder."


SOURCE: American College of Chest Physicians

[kev]

AH sure Bonnie wouldn't it just be fitting that the Irish would give us a meaningful study full of positive results ! And a seven year study none the less !


"SIOCH'AN LEAT"

GO RAIBH MAITH AGAT !!!!

Kev

[Bonnie]

Kev,
Now if they would have added "along with a wee bit of the whiskey, a good cpap, a wonderful nights sleep, ye all will be doing the Irish Jig every mornin'......"

[Guest]

Kev,
Now if they would have added "along with a wee bit of the whiskey, a good cpap, a wonderful nights sleep, ye all will be doing the Irish Jig every mornin'......"

Indeed, I had heard---down at the Irish pub that is---that that a good stiff Irish whiskey can cause restless leg syndrome immediately after rising!

Top o' the mornin' to you!

[John Dos PassosGuest]

As a Professional Engineer involved with the planning design and Construction of Teaching Hospitals in New York State University System I have learned from personal experience that most Doctors are not trained Statisticians and in many cases do not keep accurate records concerning research studies. Most of what I read in the Wall Street Journal concerning the Study failed to account for the facts that the trial subjects were compliant users and after five years were again given polysonograms and that their CPAP devices were adjusted to serve their continuing needs. Such reporting witout adequate review and blanket acceptance is frightening and dangerous because so many people accept the written word as "Truth". Frankly as a CPAP user for now ten(10) years I started out with a setting of 7cm of H2 O pressure and found after eight (8) years and a second polysonomograph that my physical aging had caused my needs to have increased to ten(10) cm of H2 Opressure. I will be eighty (80) years old next month and can tell you for a fact that I neither feel, look or act my age. I use my CPAP Device every night whether I sleep five (5) or more hours, I would not sleep without it. Most of my friends and clients believe I am twenty years younger. I am still working an average of 50 to 60 hours a week when required and I still find time to work out 4 times a week for at least 1 1/2 hours a week.
Those are facts that can be verified. I believe that the Researchers at Yale University need to restudy the use of CPAP Devices again and hire an Independent Auditor/ Account to verify the stastical profile of each participant and determine indisputibaly all of the pertinent facts. I would also recommend that any Reporter "worth their salt" also probe the facts to make sure the Facts they are reporting are accurate and not the subject of some so called " Expert's' opinion. That's what know as Responsible Reporting

[Bonnie]

Thanks for the informative post, if you've read all previous posts you'll understand there are a lot of people unhappy with the way the study was conducted. What you have said is echoed by many here. I hope you consider becoming a regular here, there are so many warm, caring people here sharing their experiences, tips and stories. And reading our Mike Moran's satire is humor only cpap people can truly relate to, and a bright spot in every day woes.

[Dave123]

I firmly believe sleep apnea is what ultimately caused my father's death. He passed away at the age of 79 from heart failure. But as long as I can remember he always snored and had trouble staying awake during the day.

Now, I the youngest son in the family am 44 and suffer the same problems. I just had my sleep study done last night and I have bad sleep apnea. But unlike my father I will get something done about it. I guess years ago nobody knew about it.

[jawz]

It's good you are getting treated. I went through about 25+ years of being tired and not knowing why. Doctors could not find anything wrong with me. They suggested going to a psychologist for depression. I told them I was not depressed. Not one single doctor suggested I get checked out for OSA.

Sleep Apnea has been known about for a long time. I had to figure out on my own that I may have it, from comments about my snoring, and that I stopped breathing in my sleep.

I think everyone that feels tired should get a sleep study. CPAP has changed my life.

In my opinion, I would rather have QUALITY in life, rather than QUANTITY. I would rather live another 20 years feeling rested and alive, then have 40 years of feeling tired all day. So whether or not using CPAP will prolong my life or not, I don't care. I will continue to use it because I feel a MILLION times better than I did before I started the therapy.

[Sleepless on LI]

Well said, jawz. I agree. Good post.

[Snorkel]

I was diagnosed with obstructive sleep apnea, very severe, about three years ago.
I have been using a cpap for three years every night and it has helped tremendously with daytime sleepiness and overall well being.
Unfortunately I have high blood pressure and diabetes.
Does that mean that using a cpap will not help reduce the risk of stroke?

[rested gal]

Snorkel, using CPAP the way you've been using it (every night for the past three years) will almost surely reduce your risk of having a stroke. Just think how much higher your blood pressure would probably be if you were not using CPAP as consistently as you are.

The study did not take into account who was really NOT using their CPAP for every sleeping moment, the way it should be done. The way you, presumably, are doing it...full time while sleeping instead of the hit or miss (mostly "miss") CPAP usage that many in the study were very likely to have been doing.

The study also lumped all "treatments" together, including notoriously ineffective ones like UPPP. (grrrrrr...that study!)

Whew, I sure put a lot of qualifiers in all that, didn't I?

almost surely
probably
presumably
very likely

Hey, keep up your good cpappin' and check with your doctor about all the control you can get in other ways over your diabetes and high blood pressure. CPAP is helping you!

is