Like men, women with severe OSA are at increased cardiovascular risk and should receive appropriate treatment.

Obstructive sleep apnea (OSA) is a recognized risk factor for cardiovascular death in men but hasn’t been well studied in women. To find out more, investigators at two sleep clinics in Spain prospectively followed 1116 women who underwent either polysomnography or respiratory polygraphy.

During a median follow-up of 72 months, 41 patients (3.6%) died of cardiovascular disease and 37 (3.3%) died of noncardiovascular disease. In untreated patients, cardiovascular mortality rates were as follows:

• Control (patients without OSA): 0.28 per 100 person-years
• Mild-to-moderate OSA: 0.94 per 100 person-years
• Severe OSA: 3.71 per 100 person-years.

Patients treated with continuous positive airway pressure (CPAP; median adherence, 6 hours per day) had cardiovascular mortality rates similar to those of control patients, regardless of OSA severity. In multivariate analysis, untreated severe OSA was an independent predictor of cardiovascular mortality; no significant difference in cardiovascular mortality risk was found among control patients, those with CPAP-treated severe OSA, those with CPAP-treated mild-to-moderate OSA, and those with untreated mild-to-moderate OSA. Sensitivity analysis by type of diagnostic sleep study did not affect the results.

Comment: In this observational study of obstructive sleep apnea in women, untreated severe OSA was associated with increased cardiovascular mortality, whereas treatment of severe OSA with continuous positive airway pressure reduced the mortality risk to that of women without OSA. All women with suggestive symptoms should be evaluated for OSA, and those with OSA should receive appropriate treatment.

Source:Journal Watch Cardiology