The proper use of the CPAP machine, indicated to treat apneas during the night, can reduce the risk of suffering serious cardiovascular events by up to 31%, as concluded by innovative research from the Lleida Biomedical Research Institute (IRBLleida) published in the prestigious Journal of the American Medical Association (JAMA).
“The results of this study have enormous clinical relevance in the management of cardiovascular risk in patients with sleep apnea,” says the scientist who led the analysis, Dr. Ferran Barbé, from the Translational Research in Respiratory Medicine group at IRBLleida and who, in 2021, was named the third most influential scientist in the international community in the field of sleep apnea.
One of the great challenges for medical researchers is to achieve advances aimed at improving people's health. Recently, a promising study has shed light on the treatment followed by patients diagnosed with obstructive sleep apnea, a common and chronic disorder that affects between 20 and 30% of the adult population and is characterized by the occlusion of the upper respiratory tract during sleep. In addition, this disorder is closely related to the high risk of also suffering from cardiovascular diseases.
According to research from the Lleida Biomedical Research Institute, the proper use of continuous positive airway pressure (CPAP) treatment for sleep apnea reduces the risk of suffering cardiovascular and cerebrovascular events again by up to 31%. This finding, which has been published in the prestigious international journal Journal of the American Medical Association (JAMA), shows that CPAP therapy is key for cardiovascular prevention in patients with obstructive sleep apnea and cardiovascular pathologies.
CPAP therapy is a treatment that involves a machine that uses mild air pressure to keep your airways open while you sleep. “The results of this study have enormous clinical relevance in the management of cardiovascular risk in patients with sleep apnea. Thus, this study highlights the importance and need for the patient treated with CPAP to comply with said treatment daily, using it throughout the entire sleep period. “These findings will change the clinical guidelines for the management of sleep apnea,” says Dr. Ferran Barbé, leader of the Translational Research in Respiratory Medicine group, at the Lleida Biomedical Research Institute (IRBLleida).
The researchers analyzed all the information on 4,186 patients from the SAVE, ISAACC and RICCADA studies, carried out in the last decade in Australia, Spain and Sweden, respectively. While the results of those clinical trials failed to demonstrate a beneficial effect of CPAP treatment, the new meta-analysis yielded promising conclusions.
Obstructive apnea causes intermittent oxygen deprivation, sleep fragmentation, and changes in intrathoracic pressure. “These three events have direct cardiovascular consequences since they cause our vessels to be rigid and are the genesis of arteriosclerosis,” explains Dr. Barbé, who delves into their future effects: “Apneic events mean that in the long run cardiovascular health is not adequate, and there is a greater risk of suffering cardiovascular events. The first will be hypertension and the most serious, a heart attack or stroke.”
Excess weight can not only cause sleep apnea, but can worsen symptoms and their relationship to cardiovascular disease. “85% of people who are in a bariatric surgery program have sleep apnea. When the surgery is effective and they lose a lot of weight, we can withdraw the treatment from many of them because they have stopped having apneas,” the doctor illustrates. Therefore, losing weight and leading a healthy lifestyle will help patients suffering from this pathology.
“The good news is that we have a treatment that works and knowledge of the disease so that patients can lead a normal life that will improve in many aspects,” highlights Dr. Barbé. Although up to 80% of people with this respiratory disorder are undiagnosed, the researcher is optimistic. “You have to see the glass half full. Nowadays there are sleep units in every hospital and there are thousands of patients receiving treatment. We have come a long way and we have to continue working and studying patients,” he says.
“Any scientist feels very satisfied when they publish in a JAMA impact journal and that only happens when you have a powerful message to convey,” says Dr. Barbé, who in 2021 was named the third most influential scientist in the international community in the field of sleep apnea by the publication Sleep and Breathing.
“What makes me proud is that the results of this study are the result of 15 years of work,” explains the specialist, who also serves as territorial clinical director of the Santa Maria University Hospital and professor at the Faculty of Medicine of the University of Lleida. (UdL). In addition, he has been scientific director of the Networked Biomedical Research Center for Respiratory Diseases (CIBERES) for nine years.
This latest study covers 15 years of work by the professionals at the Lleida IRB, but Dr. Barbé's work can be said to be a lifetime dedicated to research to improve the quality of respiratory patients. Barbé is one of the most prominent and influential figures of sleep in our country: “My guide during all these years has been to expand the knowledge that I have been receiving so that the world advances, so that those who come after will find a greater amount of knowledge to apply. And that has always been my greatest objective, to facilitate the path for those who come behind and stimulate them,” explains the doctor.
Throughout his professional career, he has collaborated closely with colleagues from all five continents and the most important publications in the scientific world have echoed the studies he has led. “The best thing is the people I have met along the way. You don't do it alone, you do it if you have someone to follow, if you do it alone you get lost,” he explains.
In Spain, at the end of the 90s, he co-founded the Spanish Sleep Network scientific community with a group of renowned pulmonologists. “We were a generation of like-minded doctors who fell in love with sleep and science, we sought to support ourselves in the promotion of sleep research in Spain. And we made Spain one of the benchmarks in sleep research. “We achieved leadership at the clinical studies level.”
Barbé, an eminence in sleep apnea in our country, is proud to have put Lleida on the map with his team. “We have been conducting research from here for 10 years. We are a pole of attraction for talent from all over the world, we have people from all countries who come here to train.”
About the future? Dr. Barbé is clear: “In the coming years, the management of sleep apnea must be in the hands of the primary care doctor.” For this reason, the researcher advocates providing them with tools to diagnose sleep apnea and treat it, in addition to referring to METASLEEP, another pioneering project of the IRBLleida, developed on patients with hypertension and applied in ten autonomous communities that will allow the expansion of the sleep model. care for patients with sleep apnea and hypertension in the rest of the national territory. “We are already on the road,” he concludes.
