Tips from Other Journals

CPAP for Reducing Ischemia in Patients with Sleep Apnea


FREE PREVIEW. AAFP members and paid subscribers: Log in to get free access. All others: Purchase online access.

FREE PREVIEW. Purchase online access to read the full version of this article.

Am Fam Physician. 2000 Apr 1;61(7):2201-2202.

Patients who have obstructive sleep apnea have a higher risk for ischemic heart diseases than the general population. The repetitive hypoxic events and sympathetic stimulation in these patients place demands on the heart that may expose patients with limited cardiac reserve to the danger of nocturnal ischemic events. Peled and associates studied nocturnal ischemic events in patients with obstructive sleep apnea and the impact of continuous positive airway pressure (CPAP) on these events.

Fifty-one patients who had an established diagnosis of obstructive sleep apnea and ischemic heart disease were enrolled in the study. Patients underwent whole-night polysomnography, including continuous Holter monitoring and ambulatory blood pressure readings. Some of the patients were treated with CPAP during the monitoring. A control group of patients without ischemic heart disease were monitored for comparison.

Nocturnal ST segment depression or ischemic events occurred in 29 percent of the patients with obstructive sleep apnea and ischemic heart disease, with some having early morning ischemia. This depression mainly occurred during the rebreathing phase of sleep apnea and was characterized by an increase in the heart rate and increased nocturnal double product values. The use of CPAP had a positive impact on both variables. In the control group with no history of ischemic heart disease, no ischemic events were recorded.

The authors conclude that obstructive sleep apnea is associated with ischemic events in patients with a history of ischemic heart disease. Treating these patients with CPAP can significantly reduce these events. They also note that a history of ischemic heart disease is the main risk factor for ischemic events in patients with obstructive sleep apnea.

Peled N, et al. Nocturnal ischemic events in patients with obstructive sleep apnea syndrome and ischemic heart disease. Effects of continuous positive air pressure treatment. J Am Coll Cardiol. November 15, 1999;34:1744–9.


Copyright © 2000 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Oct 15, 2016

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article