Sleep medicine · Does CPAP prevent cardiovascular events?
Effect of CPAP on Arrhythmia in Atrial Fibrillation and Sleep Apnea
| Design | Randomised controlled trial |
|---|---|
| Treatment | CPAP for 5 months before and during continuous rhythm monitoring |
| Control | No CPAP |
| Population | Patients with paroxysmal atrial fibrillation and sleep apnoea |
| Follow-up | 5 months |
| Primary endpoint | Burden of atrial fibrillation, as time in AF on continuous monitoring |
| Result | Mean time in atrial fibrillation fell from 5.6% at baseline to 4.1% during the last three months of CPAP, and from 5.0% to 4.3% in the control group — adjusted between-group difference -0.63 percentage points (95% CI -2.55 to 1.30, p=0.52). Seven serious adverse events (13%) occurred in the CPAP group versus two (4%) in controls. |
| Secondary endpoints | Atrial fibrillation episodes, symptoms, serious adverse events |
In patients with paroxysmal AF and SA, treatment with CPAP did not result in a statistically significant reduction in the burden of AF.
The trial authors, in the published abstract
Sleep apnoea and atrial fibrillation are tightly associated in cohort data, and treating one did not improve the other. Small and short, but consistent with the broader failure of CPAP to move cardiovascular endpoints in SAVE and Barbe 2012.
Traaen GM, Aakerøy L, Hunt TE, et al. Effect of Continuous Positive Airway Pressure on Arrhythmia in Atrial Fibrillation and Sleep Apnea: A Randomized Controlled Trial. Am J Respir Crit Care Med 2021 Sep 1;204(5):573-582.