Talking Sleep Too Much of a Good Thing? Benefits of Lower Pap Settings
Mar 7, 2025
Dr. Sanja Jelic, a prominent sleep medicine expert at Columbia University, and Dr. Daniel Gottlieb, an Associate Professor at Brigham and Women's Hospital, dive deep into the potential inflammatory effects of high-pressure PAP therapy for sleep apnea. They tackle eye-opening findings on how PAP settings might influence inflammatory markers and challenge existing beliefs about CPAP efficacy. Plus, they explore innovative alternatives like supplemental oxygen and advocate for personalized treatment to enhance cardiovascular health and overall outcomes in sleep medicine.
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PAP Therapy and Cardiovascular Outcomes
- Studies have shown insufficient evidence to support PAP therapy for OSA solely to improve cardiovascular outcomes.
- This has sparked debate about the reasons, including data quality, study design, and other unknown factors.
CPAP's Pro-Inflammatory Effect
- Contrary to expectations, CPAP therapy seems to increase inflammatory biomarkers like Angiopoietin-2, rather than decrease them.
- This unexpected trend was observed across multiple cohorts and a randomized trial.
Inflammatory Markers and PAP Therapy
- Angiopoietin-2 levels are higher in OSA patients and increase further with PAP therapy.
- VEGF levels, considered cardioprotective, decrease with CPAP, potentially offsetting benefits.