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Sleep Apnea Mortalities

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Biguglygremlin +0 points · 7 months ago Original Poster Sleep Enthusiast

I read something today and it seemed rather interesting, perhaps even pertinent to some recent discussions in this forum, but then I fried my last few neurons, so I thought I would link the study here and see if someone could simplify it for me or at least comment on it.

Mortality in Sleep Apnea Patients: A Multivariate Analysis of Risk Factors

You'll need to read the PDF.

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Biguglygremlin +0 points · 7 months ago Original Poster Sleep Enthusiast

I hadn't realized how old that study was.

I suppose it is still relevant but I wonder if there are more recent studies of a similar scale that are as detailed and circumspect.

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Sierra +0 points · 7 months ago Sleep Patron

The key point in the study seems to be.

"These results were interpreted to suggest that SAS [sleep apnea syndrome] affects death ' indirectly, most probably by being a risk factor for hypertension."

An interesting study would be to determine if CPAP reduces this risk or not. From what I could see, CPAP treatment was not used in this study.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Enthusiast

I have to be in the right place to understand a study like the one linked above and I find it harder and harder to get to that place nowadays.

It seems to me that there can be no reliable studies into the long-term benefits of CPAP.

At the moment any study in this field is like studying Cartier watch owners and concluding that they live longer and remain mobile and functional well beyond most people who don't have Cartier watches therefore Cartier watches must be therapeutic and prevent many fatal illnesses.

Cartier Watch

Undoubtedly if we all had Cartier watches we would also enjoy some of those health benefits but do these watches cure diseases or would we need to sell them to raise the funds for the associated lifestyle and the additional health services and interventions that are part of that lifestyle?

What I would like to see is studies of the non-compliant and those with full health benefits or money who refused to have or use a CPAP but even then there would be issues with motivation and personality and life choices because the reasons for rejecting CPAP would likely affect other medical and lifestyle choices.

Then there is the issue that you can't study anything without having an impact on the subjects of your study ............. :(

I do want to get back to the above mortality study one day when I can find a few spare neurons because it seemed to me to be both thorough and cautious and especially because it hinted at significant differences between Apnea groups.

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SusanR +0 points · about 2 months ago Sleep Commentator Researcher

There have been some more recent studies on mortality (particularly due to heart disease) and Sleep Apnea.

Our research time found that the severity of drops in oxygen after each apnea or hypopneas was predictive to increased mortality:https://pubmed.ncbi.nlm.nih.gov/30376054/.

Other "observational" studies have shown that those using CPAP regularly may be "protected" from an increased mortality risk; but randomized controlled studies have not yet provided the convincing data that CPAP does improve outcomes in patients with cardiovascular risk factors without high levels of sleepiness (the types of patients studies in trials). Please look at the AHRQ recommendation I posted and provide input to their recommendations and needs for the sleep apnea community. thanks

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Biguglygremlin +0 points · about 2 months ago Original Poster Sleep Enthusiast

Hello again SusanR,

I presume the AHRQ refers to your thread regarding the U.S. Preventive Services Task Force. I doubt that they would be interested in a response from the other side of the planet and certainly not my views on expanding the scope of entrapment that screening adults without symptoms is likely to become.

I trust that you will forgive my scepticism and lack of tact but it always amuses me that researchers make such profound discoveries, proving that those with the worst symptoms have the worst outcomes. Who would have guessed it? (I do, however, love the implications regarding AHI readings)

If I set aside my wayward thoughts I am still left wondering where this study was conducted and on what demographics because the study would have been invalid if they had all been concerned enough about their health to take preventative measures, and had the means to seek medical support and finance appropriate steps to limit not just the risk presented by desaturation but also the many other lifestyle and medical factors that contribute to early death from cardiac events.

I know that it is incredibly presumptuous for me, a total ignoramus to question the significance of such scientific research.

Most likely, when the morning light drives back the darkness, I will repent and apologise for my foolish indiscretions.

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SusanR +0 points · about 2 months ago Sleep Commentator Researcher

I appreciate your skepticism!

I dont think input to the AHRQ report is limited to any geographically area- good, constructive input from anyone affected by sleep apnea should be encouraged.

The recommendations made were based on the totality of data available in the literature-the largest studies are international trials.

the specific mortality study I referenced in from two community-based cohorts from multiple cites across the US. The important point is that these were not "patients" but people who are part of ongoing observational studies. In that community context even those with OSA often dont get treated even when given "feedback".

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Biguglygremlin +0 points · about 2 months ago Original Poster Sleep Enthusiast

It's still not daylight here so dare I ask how these people are studied and for what purpose? Why do they consent or don't they have to? Is it essentially a survey style study?

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Biguglygremlin +0 points · about 2 months ago Original Poster Sleep Enthusiast

None of this is relevant to what I consider to be the primary issue which is that unbiased statistics cannot be generated in the field of CPAP even without an agenda because there isn't a level playing field. The factors that enable groupings also discredit the results.

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Biguglygremlin +0 points · about 2 months ago Original Poster Sleep Enthusiast

Ok, I repent! I am sorry for my seeming disrespect.

That study achieved some significant results.

Results which will encourage, and help set the parameters for, future research.

I did aim for enthusiasm, but it's a gloomy day here with no hope of reprieve anytime soon, and flood warnings all over the place, again.

Maybe I should spend some time researching and ordering a battery backup for my CPAP and make a resolution that our next house will be further from the river.

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SusanR +0 points · about 2 months ago Sleep Commentator Researcher

No problem! We need to figure out how to best communicate our research to the patient community

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Biguglygremlin +0 points · about 2 months ago Original Poster Sleep Enthusiast

Lol if only the community was more patient!

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