Adherence to CPAP treatment reduces the risk of hospital readmission in adults with comorbid sleep apnea and heart disease

Adherence to CPAP treatment reduces the risk of hospital readmission in adults with comorbid sleep apnea and heart disease

Consistent use of CPAP treatment in patients with known heart disease and newly diagnosed obstructive sleep apnea is associated with a lower likelihood of hospital readmission, according to a new study.

Results show that the risk of 30-day hospital readmission was 60% lower in patients with cardiovascular disease and high CPAP compliance for sleep apnea compared to patients with low CPAP compliance. The findings highlight the importance of screening and treating obstructive sleep apnea in people with cardiovascular disease, the authors wrote.

“Cardiovascular disease is the number one cause of death in older adults worldwide,” said corresponding author Jennifer Albrecht, who has a doctorate in epidemiology and is an associate professor of epidemiology and public health at the University of Maryland School of Medicine in Baltimore. "Older adults with comorbid cardiovascular disease and obstructive sleep apnea are a vulnerable population with a high risk of rehospitalization. Our data show that successful treatment of obstructive sleep apnea can significantly reduce the risk of a 30-day hospitalization."

The study was published August 8 as an accepted article in the online Journal of Clinical Sleep Medicine. the official publication of the American Academy of Sleep Medicine.

Nearly 30 million adults in the United States suffer from obstructive sleep apnea, a chronic condition in which the upper airway repeatedly collapses during sleep. It is found in 40%-60% of people diagnosed with cardiovascular disease. Obstructive sleep apnea is commonly treated with CPAP therapy, which uses gentle air pressure delivered through a mask to keep the airway open during sleep.

The retrospective cohort study examined Medicare beneficiaries with cardiovascular disease newly diagnosed with obstructive sleep apnea between 2009 and 2013 who were started on CPAP and hospitalized. Of the 1,301 patients who met study criteria, the median age was 73 years and 53% were men. The 30-day readmission rate over the two-year period after CPAP initiation was 10.2%. 33% of study participants had low CPAP adherence, 38% had partial adherence, and 28.5% had high adherence. Compared to low adherence, Medicare beneficiaries with high adherence were 60% less likely to be readmitted to the hospital within 30 days.

Obstructive sleep apnea is easily treatable and treatment improves quality of life. The treatment can also reduce 30-day readmissions, a major driver of healthcare costs in the United States. If patients show signs of obstructive sleep apnea, such as snoring, daytime sleepiness, or poor sleep quality, they should talk to their doctor, and doctors should ask about sleep, especially when caring for older adult patients with cardiovascular disease.

Jennifer Albrecht, associate professor of epidemiology and public health, University of Maryland School of Medicine

Source:

American Academy of Sleep Medicine

Reference:

Doyinsola Bailey, M., et al. (2022) Adherence to continuous positive airway pressure reduces the risk of 30-day hospitalization in older adults with comorbid obstructive sleep apnea and cardiovascular disease. Journal of Clinical Sleep Medicine. doi.org/10.5664/jcsm.10196.

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