Men with a severe form of obstructive sleep apnoea-
hypopnoea have an increased risk of fatal and non-fatal
cardiovascular events, concludes a study published in this week's
issue of The Lancet.

Obstructive sleep apnoea-hypopnoea affects 4 percent of
middle-aged men and 2 percent of middle-aged women.
Individuals with the condition regularly stop breathing during sleep
for 10 seconds or longer (apnoea) and have slowed breathing
(hypopnoea). It is associated with high rates of illness and mortality.
Previous studies have linked it with an increased risk of
cardiovascular disease but these have not taken into account
potential confounding factors. After adjustment for age and obesity
such studies have not been able to show an increased risk.

Jose Marin, MD, from the Hospital Universitario Miguel Servet,
Spain, and colleagues recruited 264 healthy men matched for age
and body mass index, 377 simple snorers, 403 with untreated
severe disease and 372 with the disease and treated with
continuous positive airway pressure (CPAP).

Participants were  followed-up at least once a year for an average of 10 years. Patients with untreated severe disease had a higher incidence of fatal cardiovascular events (1.06 per 100 person-years) and non-fatal cardiovascular events (2.13 per 100 person-years) than untreated patients with mild-moderate disease, simple snorers, patients treated with CPAP and healthy participants -- even after adjustment for potential confounding factors.

Marin concludes: "The results of this large, long-term,
prospective controlled study suggest that in untreated men with
severe obstructive sleep apnoea-hypopnoea, the risk of fatal and
non-fatal cardiovascular events is increased. There is a relation
between the severity of this disease and cardiovascular risk, but
effective treatment with nasal CPAP significantly reduces the
cardiovascular outcomes associated with this medical condition.
Simple snoring is not a significant cardiovascular risk factor."

Source: The Lancet