Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study.

• Published in: European Respiratory Journal
• Main Authors: Keenan, Brendan T, Maislin, Greg, Sunwoo, Bernie Y, Arnardottir, Erna Sif, Jackson, Nicholas, Olafsson, Isleifur, Juliusson, Sigurdur, Schwab, Richard J, Gislason, Thorarinn, Benediktsdottir, Bryndis, Pack, Allan I
• Other Authors: Univ Penn, Ctr Sleep & Circadian Neurobiol, Philadelphia, PA 19104 USA, Univ Penn, Dept Med, Div Sleep Med, Philadelphia, PA 19104 USA, Univ Penn, Dept Med, Div Pulm Allergy & Crit Care, Philadelphia, PA 19104 USA, Natl Univ Hosp Iceland, Landspitali, Dept Resp Med & Sleep, Reykjavik, Iceland, Univ Iceland, Fac Med, Reykjavik, Iceland, Natl Univ Hosp Iceland, Landspitati, Dept Clin Biochem, Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: European Respiratory Society 2014
• Subjects: Kæfisvefn; Blóðfita; Hjartasjúkdómar; Offita; Æðakölkun; Prótín; Sleep Apnea; Obstructive/therapy; Cardiovascular Diseases; Dyslipidemias; Atherosclerosis; Obesity; Continuous Positive Airway Pressure; Lipoproteins; Iceland
• Online Access: http://hdl.handle.net/2336/325858; https://doi.org/10.1183/09031936.00043614

To access publisher's full text version of this article click on the hyperlink at the bottom of the page Obstructive sleep apnoea (OSA) is associated with cardiovascular disease. Dyslipidaemia has been implicated as a mechanism linking OSA with atherosclerosis, but no consistent associations with lipids exist for OSA or positive airway pressure treatment. We assessed the relationships between fasting lipid levels and obesity and OSA severity, and explored the impact of positive airway pressure treatment on 2-year fasting lipid level changes. Analyses included moderate-to-severe OSA patients from the Icelandic Sleep Apnoea Cohort. Fasting morning lipids were analysed in 613 untreated participants not on lipid-lowering medications at baseline. Patients were then initiated on positive airway pressure and followed for 2 years. Sub-classification using propensity score quintiles, which aimed to replicate covariate balance associated with randomised trials and, therefore, minimise selection bias and allow causal inference, was used to design the treatment group comparisons. 199 positive airway pressure adherent patients and 118 non-users were identified. At baseline, obesity was positively correlated with triglycerides and negatively correlated with total cholesterol, and low-density and high-density lipoprotein cholesterol. A small correlation was observed between the apnoea/hypopnoea index and high-density lipoprotein cholesterol. No effect of positive airway pressure adherence on 2-year fasting lipid changes was observed. Results do not support the concept of changes in fasting lipids as a primary mechanism for the increased risk of atherosclerotic cardiovascular disease in OSA. National Institutes of Health HL094307 Eimskip Fund of the University of Iceland Landspitali University Hospital Science Fund