CPAP adherence linked to improved atherogenic lipid profiles in adults with moderate-severe OSAS

This retrospective-prospective cohort study examined 104 adults with moderate-severe obstructive sleep apnea syndrome (OSAS) at a single center. The intervention was adherent continuous positive airway pressure (CPAP) therapy, defined as device-verified use ≥4 hours per night on ≥70% of nights, compared to pre-therapy baseline. The primary outcome was the association between nocturnal hypoxemia burden (percentage of total sleep time with SpO₂ <90%, or %T90/TST) and atherogenic indices (AIP, CRI-I, CRI-II).

Main results showed that higher %T90 was associated with progressively more atherogenic lipid profiles. Specifically, positive associations were found between %T90 and both LDL-C (p=0.027) and total cholesterol (TC) (p=0.027), though exact effect sizes and absolute numbers were not reported. Secondary outcomes included pre-post changes in atherogenic indices after ≥3 months of CPAP therapy, with findings suggesting improvement in these cardiovascular risk markers among adherent patients.

Safety and tolerability data were not reported. Key limitations include the observational design, which prevents causal conclusions, and the single-center setting with modest sample size. Funding sources and conflicts of interest were not disclosed. The practice relevance is restrained: while these findings add to evidence linking CPAP adherence with potential cardiovascular benefit markers, they require confirmation in controlled trials before influencing clinical management beyond standard OSAS care.