Data were analysed from the Système National des Données de Santé (SNDS) database, the French national health insurance reimbursement system, for all new CPAP users ≥ 18 years of age. The French SNDS is currently one of the best anonymized claims databases in the world because of its size (600 terabytes) and its unbiased recruitment (including > 99% of the total French population).
Over a 3-year observation period, death occurred in 3,204 of 88,007 patients (3.6%) in the CPAP therapy termination group compared with 2,053 of 88,007 patients (2.3%) in the therapy continuation group
The cumulative incidence of heart failure was significantly lower in patients who continued vs terminated CPAP therapy (HR, 0.77; 95% CI, 0.71-0.82; P < .01). During follow-up, incident hypertension and heart failure occurred significantly less frequently in patients with OSA who continued vs terminated CPAP therapy. In addition, a trend toward a lower risk of new hospitalizations for diabetes in the therapy continuation vs therapy termination group was found (P = .06)
This study showed that continued use of CPAP during the first year after therapy initiation is associated with a significant reduction in mortality in a large national cohort of patients with OSA compared with CPAP therapy termination. This finding adds to a growing body of evidence for the beneficial effects of CPAP use on survival.
