Long-Term Survival of Patients With Obstructive Sleep Apnea Treated by Uvulopalatopharyngoplasty or Nasal CPAP – Conclusion
There is some support for this explanation in that we found no difference in survival between UPPP responders and nonresponders. In elderly patients the effect of OSA on longterm survival is less clear. Ancoli-Israel and colleagues showed an association between OSA and decreased survival in elderly women but not in men. Bliwise and coworkers demonstrated no difference in mortality in a group of treated and untreated elderly patients with OSA compared with controls.
The major cause of increased mortality in OSA appears to be cardiovascular in nature. Partinen and associates found an age-adjusted odds ratio of vascular mortality of 4.7. Long-term follow-up of the same patients has shown a relative risk of developing new vascular problems of 2.3 (95 percent confidence interval of 1.5 to 3.6). Obstructive sleep apnea is associated with significant cardiac arrhythmias and cyclical variation of systemic blood pressure during sleep. Both chronic snoring, which usually precedes the onset of florid OSA, and OSA have been shown to be significant risk factors for the development of cardiovascular and cerebrovascular disease. The combined effects of systemic hypertension, hypoxemia, and increased sympathetic activity during sleep are thought to promote the development of atherosclerosis. canadian healthcare mall