Dados do Trabalho

Título

Impact of Treating Obstructive Sleep Apnea with Continuous Positive Airway Pressure (CPAP) on the prevention of cardiovascular events in patients with Metabolic Syndrome: a systematic review

Introdução

Obstructive Sleep Apnea (OSA) is a condition in which the upper airway (UA) collapses intermittently during sleep, resulting in total (apnea) and partial (hypopnea) obstructions, associated with Metabolic Syndrome characteristics. These breathing pause episodes increase breathing effort and reduce intrathoracic pressure, raising ventricular transmural pressure and causing cyclic drops in oxygen saturation (intermittent hypoxia) and micro-arousals, leading to fragmented and shallow sleep. Intermittent hypoxia worsens cardiovascular effects during sleep.
The standard treatment for moderate to severe OSA is the use of a Continuous Positive Airway Pressure (CPAP) device. This device keeps the upper airways open during sleep, resulting in increased oxygen saturation in the blood and reduced awakenings associated with respiratory events.

Objetivo

The objective of this systematic review is to understand the impact of CPAP use on cardiometabolic parameters in patients with Obstructive Sleep Apnea Syndrome and Metabolic Syndrome, in order to prevent cardiovascular events.

Métodos

Inclusion criteria were randomized controlled trials with patients with Metabolic Syndrome and Obstructive Sleep Apnea receiving treatment with Continuous Positive Airway Pressure. The outcome assessed was the improvement in cardiometabolic parameters for prevention of cardiovascular events. Chosen databases were PubMed-MEDLine and Biblioteca Virtual em Saúde. Google Spreadsheets was used for data synthesis and presentation.

Resultados

A total of 13 articles were included for data extraction. The use of CPAP resulted in no or minimal changes in the initial state of the metabolic and cardiovascular profile of most patients. However, groups that showed some form of beneficial change after CPAP treatment were those that had a small change in Systemic Arterial Hypertension. Furthermore, metabolic disorder indices, such as insulin resistance, lipid profile, obesity and leucine, did not undergo significant changes after using the selected intervention. Most of the effects described are related to the reduction of systolic and diastolic pressure but no or little change in the metabolic profile of these patients.

Conclusões

​CPAP treatment does not bring great benefits to the cardiovascular and metabolic profile of patients with Obstructive Sleep Apnea Syndrome and Metabolic Syndrome. However, it is essential to carry out more studies with an emphasis on this topic.

Palavras -chave

Obstructive Sleep Apneas, CPAP Ventilation, Metabolic Syndromes