Key result
CPAP reduces total cholesterol by ~0.1 mmol/L versus controls but leaves other lipids unchanged.
Why the study?
The effects of continuous positive airway pressure treatment on lipid profiles in obstructive sleep apnea patients are unclear.
Does continuous positive airway pressure (CPAP) treatment improve lipid profiles in patients with obstructive sleep apnea?
Meta-Analysis (n=1,792)
Does continuous positive airway pressure (CPAP) treatment improve lipid profiles in patients with obstructive sleep apnea?
CPAP treatment in OSA patients yields a statistically significant but clinically small reduction in total cholesterol, without affecting other lipid parameters.
Answers are grounded in this paper and cite their sources.
Small total cholesterol reduction with CPAP unlikely to change lipid management in OSA; confirms modest, isolated metabolic effect.
Background: Obstructive sleep apnea (OSA) is associated with dyslipidemia. However, the effects of continuous positive airway pressure (CPAP) treatment on lipid profiles are unclear. Methods: PubMed/Medline, Embase and Cochrane were searched up to July 2021. Randomized controlled trials (RCTs) of CPAP versus controls with ≥4 weeks treatment and reported pre- and post-intervention lipid profiles were included. Weighted mean difference (WMD) was used to assess the effect size. Meta-regression was used to explore the potential moderators of post-CPAP treatment changes in lipid profiles. Results: A total of 14 RCTs with 1792 subjects were included. CPAP treatment was associated with a significant decrease in total cholesterol compared to controls (WMD = −0.098 mmol/L, 95% CI = −0.169 to −0.027, p = 0.007, I2 = 0.0%). No significant changes in triglyceride, high-density lipoprotein nor low-density lipoprotein were observed after CPAP treatment (all p > 0.2). Furthermore, meta-regression models showed that age, gender, body mass index, daytime sleepiness, OSA severity, follow-up study duration, CPAP compliance nor patients with cardiometabolic disease did not moderate the effects of CPAP treatment on lipid profiles (all p > 0.05). Conclusions: CPAP treatment decreases total cholesterol at a small magnitude but has no effect on other markers of dyslipidemia in OSA patients. Future studies of CPAP therapy should target combined treatment strategies with lifestyle modifications and/or anti-hyperlipidemic medications in the primary as well as secondary cardiovascular prevention models.
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Chen et al. (2022) conducted a meta-analysis in Obstructive sleep apnea (OSA) (n=1,792). Continuous positive airway pressure (CPAP) vs. controls was evaluated on total cholesterol (WMD -0.098 mmol/L, 95% CI -0.169 to -0.027, p=0.007). CPAP treatment significantly decreased total cholesterol compared to controls (WMD -0.098 mmol/L; 95% CI -0.169 to -0.027; p=0.007), but had no effect on other markers of dyslipidemia.
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