Sleep Board Review Test 1

15. The Canadian Continuous Positive Airway Pressurefor Patients with Central Sleep Apnea and Heart Failure (CANPAP Trial) demonstrated that:

a. patients with obstructive sleep apnea and CHF had increased left ventricular ejection fraction with the use of CPAP

b. patients with central sleep apnea treated with CPAP had increased transplantation free survival at 12 months

c. patients with central sleep apnea treated with CPAP had no difference in transplantation free survival at 3 yrs.

d. patients with obstructive sleep apnea treated with CPAP had decreased mortality at 12 months compared to the placebo group

e. patients with central sleep apnea treated with CPAP had a higher risk of death at 3 yrs compared to the placebo group.

Answer: c. patients with central sleep apnea treated with CPAP had no difference in transplantation free survival at 3 yrs.

The CANPAP trial enrolled with patients with CHF, a LVEF < 40%, and central sleep apnea defined as 15 or more apneas and hypopneas/hr with at least 50% of events being central. This was not a study of OSA. Patients treated with CPAP had worse outcome in the first 18 months of therapy (hazard ratio of 1.5, p=0.02) which reversed to a trend for improvement in the CPAP group (hazard ratio 0.66, p = 0.06)

Reference:

Bradley TD, et al. NEJM 2005;353:2025-2033.

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