Positive airway pressure (PAP) utilization is associated with lower all-cause mortality and major adverse cardiovascular event (MACE) incidence in older adults with obstructive sleep apnea (OSA), according to a study published online Sept. 11 in JAMA Network Open.

Diego R. Mazzotti, Ph.D., from the University of Kansas Medical Center in Kansas City, and colleagues sought to determine whether PAP initiation and utilization are associated with lower mortality and incidence of MACE among older U.S. adults with OSA. The analysis included 888,835 Medicare beneficiaries with two or more distinct OSA claims identified from multistate, statewide, multiyear Medicare fee-for-service claims data (2011 to 2020) with follow-up until death or censoring through 2020.

The researchers found that during a median follow-up of 3.1 years, those with evidence of PAP initiation (32.6 percent) had significantly lower all-cause mortality (hazard ratio, 0.53) and MACE incidence risk (hazard ratio, 0.90). There was a progressive association between higher quartiles of annual PAP claims and lower mortality and MACE incidence risk.

“These results might inform future trials assessing the importance of obstructive sleep apnea therapies toward minimizing cardiovascular risk and mortality in older adults,” the authors write.

One author disclosed being a cofounder of Hypnoscure.

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