Sleep apnea and kidney function: does CPAP help?

1. Summary

Obstructive sleep apnea (OSA) is a sleep health problem whereby episodes of interrupted breathing are caused by collapsing or blockage of the airways. As they don't sleep well, people with OSA often feel tired during the day, and OSA is associated with known health risks, like high blood pressure and obesity, and high risk of cardiovascular disease.

The main treatment option for OSA is continuous positive airway pressure (CPAP), which prevents airway obstruction and helps people keep breathing easily. Usually patients who use CPAP find that it reduces their daytime sleepiness.

A recent large clinical trial called SAVE (Sleep Apnea cardioVascular Endpoints) was designed to find out whether CPAP also reduces the risk of cardiovascular problems, like stroke or heart failure. Some people in SAVE were also asked to be involved in a substudy where urine and blood were collected to look at kidney function. Generally kidney efficiency declines with age, is known to be affected by high blood pressure, and might be sensitive to the reduction in oxygen in the blood that happens when people are not breathing effectively. It was thought that CPAP might prevent kidney damage in the long term by maintaining better supply of oxygen overnight, and reducing the surges of blood pressure that occur with pauses in breathing.

Data from this SAVE substudy shows that this was not the case. People who were prescribed and used a CPAP machine to help with their OSA still had kidney problems at a similar rate to the other participants who did not have CPAP. Their kidney filtration efficiency still declined gradually over time.

It seems that treating OSA with CPAP, while people feel better, won't make much difference to their kidneys, and other risk factors like blood pressure and diabetes are more important.

2. Share a PubMed or DOI link to article

3. Do you have any ideas to expand upon this research? Are you looking for collaborators?

There are several projects ongoing using information from the wealth of data collected during the SAVE clinical trial. Current topics of interest include looking at the effect of CPAP on blood pressure over a very long time period, participants' reported quality of life, and whether we can use information gathered at the start of the trial to build better predictive tools about health risks and patterns of disease.

People with an idea that they think is new and might be able to be investigated using the SAVE data are welcome to contact the SAVE team to discuss their topic.


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