Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Kevin Basile, MD

Abstract

Introduction: Cardiovascular disease is one of the most prevalent illnesses worldwide and the leading cause of death in the United States. Obstructive sleep apnea (OSA) has been found to be a risk factor correlated to cardiovascular disease and events. Treatment for OSA includes the use of continuous positive airway pressure (CPAP), but patients are often non-compliant due to discomfort. Therefore, the following clinical question arises: [P] In an adult patient (35-75 years old) diagnosed with OSA, [I] does the use of CPAP [C: compared to patients with OSA who do not use CPAP] [O]decrease the risk and/or progression of cardiovascular disease (CVD)?

Methods: A literature search was conducted in November 2019 using the PubMed, EBSCO, and google scholar. Six articles were selected based on their relevance to the research question, study design, outcome measurements, and results.

Results: The literature review of the articles showed a promising effect of CPAP treatment on lessening the progression of cardiovascular risk in patients diagnosed with OSA. The study design, sample size, age range, OSA criteria, duration, CPAP compliance, and outcome measurements are critically analyzed to determine the validity and significance.

Discussion: The results are used to evaluate the overall power of the studies in reference to validity, such as blinded status, sample size, bias, and duration. Three of the six articles are determined to be adequately valid, while the remaining three are considered marginal.

Conclusion: Although statistical and clinical significance is found in overall survival, the reoccurrence of cardiovascular events is not statistically significant. Therefore, current clinical practice should remain and further research with a larger, diverse sample size should be conducted.

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The Use of Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea to Decrease the Risk and Progression of Cardiovascular Disease

Introduction: Cardiovascular disease is one of the most prevalent illnesses worldwide and the leading cause of death in the United States. Obstructive sleep apnea (OSA) has been found to be a risk factor correlated to cardiovascular disease and events. Treatment for OSA includes the use of continuous positive airway pressure (CPAP), but patients are often non-compliant due to discomfort. Therefore, the following clinical question arises: [P] In an adult patient (35-75 years old) diagnosed with OSA, [I] does the use of CPAP [C: compared to patients with OSA who do not use CPAP] [O]decrease the risk and/or progression of cardiovascular disease (CVD)?

Methods: A literature search was conducted in November 2019 using the PubMed, EBSCO, and google scholar. Six articles were selected based on their relevance to the research question, study design, outcome measurements, and results.

Results: The literature review of the articles showed a promising effect of CPAP treatment on lessening the progression of cardiovascular risk in patients diagnosed with OSA. The study design, sample size, age range, OSA criteria, duration, CPAP compliance, and outcome measurements are critically analyzed to determine the validity and significance.

Discussion: The results are used to evaluate the overall power of the studies in reference to validity, such as blinded status, sample size, bias, and duration. Three of the six articles are determined to be adequately valid, while the remaining three are considered marginal.

Conclusion: Although statistical and clinical significance is found in overall survival, the reoccurrence of cardiovascular events is not statistically significant. Therefore, current clinical practice should remain and further research with a larger, diverse sample size should be conducted.