Positive Airway Pressure Therapies and Oxygen Therapy in Obstructive Sleep Apnea (OSA): 5-Year Survival
Abstract
1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Variables
2.3. Sample Size
2.4. Data Analysis
3. Results
3.1. General Characteristics of the Population
3.2. Medical History and Comorbidities of the Population
3.3. Treatment Adherence
3.4. Survival Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| OSA | Obstructive Sleep Apnea |
| CPAP | Continuous Positive Airway Pressure |
| Auto-CPAP | Automatic Continuous Positive Airway Pressure |
| BiPAP | Bilevel Positive Airway Pressure |
| AHI | Apnea–Hypopnea Index |
| PSG | Polysomnography |
| AASM | American Academy of Sleep Medicine |
| HR | Hazard Ratio |
| CI | Confidence Interval |
| HIV | Human Immunodeficiency Virus |
| AIDS | Acquired Immune Deficiency Syndrome |
| Sd | Standard Deviation |
| M | Median |
| IQR | Interquartile Range |
| BMI | Body Mass Index |
| COPD | Chronic Obstructive Pulmonary Disease |
| REDCap | Research Electronic Data Capture |
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| Total Population n = 3039 | Alive n = 2863 | Deceased n = 176 | p-Value | |
|---|---|---|---|---|
| Age (years) x (sd) | 59.6 (13.93) | 58.8 (13.63) | 72.2 (12.72) | <0.001 |
| >65 years n (%) | 1126 (37.1) | 993 (34.7) | 133 (75.6) | <0.001 |
| Male n (%) | 1818 (59.8) | 1712 (59.8) | 106 (60.2) | 0.910 |
| Anthropometric measurements | ||||
| Weight Kg x (sd) | 80 (15.67) | 80.3 (15.64) | 75.6 (15.62) | <0.001 |
| Height Mt’s x (sd) | 1.63 (0.1) | 1.64 (0.1) | 1.61 (0.09) | <0.001 |
| BMI Kg/m2 x (sd) | 30 (5.34) | 30 (5.28) | 29 (6.14) | 0.039 |
| Symptoms | ||||
| Daytime hypersomnia n (%) | 1126 (43.4) | 1068 (43.8) | 58 (37.2) | 0.104 |
| Insomnia n (%) | 751 (29.3) | 709 (29.5) | 42 (27.1) | 0.530 |
| Snoring n (%) | 1384 (53.2) | 1317 (53.9) | 67 (42.9) | 0.008 |
| Tired-fatigued n (%) | 765 (29.8) | 722 (30) | 43 (27.6) | 0.522 |
| Observed_Apneas n (%) | 1063 (42.1) | 998 (42.1) | 65 (42.2) | 0.974 |
| Neck diameter x (sd) | 41.3 (5.14) | 41.3 (5.17) | 40.9 (4.35) | 0.194 |
| CPAP Adherence | ||||
| Days of CPAP use x (sd) | 69.5 (20.13) | 69.9 (19.84) | 60.2 (26.09) | <0.001 |
| CPAP Adherence % x (sd) | 77.6 (21.82) | 78 (21.47) | 66.9 (28.99) | <0.001 |
| Days of use greater than 4 h x (sd) | 68.6 (29.92) | 69.2 (28.09) | 62.1 (50.79) | 0.067 |
| Average hours of CPAP use M (IQR) | 5.2 (4–6.53) | 5.5 (3.7–7.58) | 5.2 (4–6.5) | 0.992 |
| Residual AHI M (IQR) | 8.9 (3–27.8) | 15 (4.05–29.3) | 8.5 (3–27.6) | 0.110 |
| Total Population n = 3039 | Alive n = 2863 | Deceased n = 176 | p-Value | |
|---|---|---|---|---|
| Medical History n (%) | ||||
| Smoking | 1222 (40.3) | 1123 (39.3) | 99 (56.3) | <0.001 |
| Hypertension | 1875 (61.7) | 1728 (60.4) | 147 (83.5) | <0.001 |
| Depression | 298 (9.8) | 276 (9.6) | 22 (12.5) | 0.217 |
| Alcohol use | 170 (5.6) | 147 (5.1) | 23 (13.1) | <0.001 |
| Myocardial infarction | 339 (11.2) | 301 (10.5) | 38 (21.6) | <0.001 |
| Atrial fibrillation | 218 (7.2) | 176 (6.2) | 42 (23.9) | <0.001 |
| Congestive heart failure | 355 (11.7) | 286 (10) | 69 (39.2) | <0.001 |
| Peripheral vascular disease | 190 (6.3) | 169 (5.9) | 21 (11.9) | 0.001 |
| Cerebrovascular disease | 229 (7.5) | 194 (6.8) | 35 (19.9) | <0.001 |
| Dementia | 151 (5) | 117 (4.1) | 34 (19.3) | <0.001 |
| Chronic lung disease | 689 (22.7) | 583 (20.4) | 106 (60.2) | <0.001 |
| Connective tissue disease | 214 (7) | 191 (6.7) | 23 (13.1) | 0.001 |
| Peptic ulcer | 354 (11.7) | 330 (11.5) | 24 (13.6) | 0.399 |
| Non-malignant liver disease | 265 (8.7) | 249 (8.7) | 16 (9.1) | 0.900 |
| Liver disease | 67 (2.2) | 60 (2.1) | 7 (4) | 0.099 |
| Diabetes | 659 (21.7) | 586 (20.5) | 73 (41.5) | <0.001 |
| Diabetes with end-organ damage | 89 (3.1) | 73 (2.7) | 16 (9.4) | <0.001 |
| Hemiplegia/stroke sequelae | 88 (3.1) | 73 (2.7) | 15 (8.8) | <0.001 |
| Renal failure | 216 (7.1) | 177 (6.2) | 39 (22.2) | <0.001 |
| Leukemia | 8 (0.3) | 7 (0.2) | 1 (0.6) | 0.416 |
| Lymphoma | 14 (0.5) | 12 (0.4) | 2 (1.1) | 0.173 |
| Other types of cancer | 263 (8.7) | 221 (7.7) | 42 (24) | <0.001 |
| Metastasis | 37 (1.3) | 19 (0.7) | 18 (10.5) | <0.001 |
| HIV/AIDS | 5 (0.2) | 4 (0.1) | 1 (0.6) | 0.174 |
| Traffic accidents | 119 (3.9) | 107 (3.7) | 12 (6.8) | 0.041 |
| Total Population | Alive | Deceased | p-Value | |
|---|---|---|---|---|
| Adherent CPAP or Auto-CPAP n (%) | 2454 | 2345 (95.6) | 109 (4.4) | <0.001 |
| Non-adherent CPAP or Auto-CPAP n (%) | 140 | 133 (95) | 7 (5) | |
| Adherent BiPAP n (%) | 186 | 175 (94.1) | 11 (5.9) | |
| Non-Adherent BiPAP n (%) | 12 | 11 (91.7) | 1 (8.3) | |
| Oxygen Use n (%) | 247 | 199 (80.6) | 48 (19.4) |
| Hazard Ratio | 95% Confidence Interval (CI) | p-Value | ||
|---|---|---|---|---|
| Positive pressure treatment | 1.204 | 1.032 | 1.404 | 0.018 |
| Age (years) | 1.051 | 1.032 | 1.070 | <0.001 |
| Sex | 1.120 | 0.761 | 1.647 | 0.565 |
| Body mass index | 0.981 | 0.946 | 1.017 | 0.289 |
| Smoking history | 0.990 | 0.686 | 1.427 | 0.955 |
| Hypertension | 1.114 | 0.657 | 1.889 | 0.690 |
| Alcohol use | 1.423 | 0.825 | 2.456 | 0.205 |
| Myocardial infarction | 1.035 | 0.684 | 1.566 | 0.871 |
| Atrial fibrillation | 1.208 | 0.783 | 1.863 | 0.392 |
| Congestive heart failure | 2.198 | 1.463 | 3.302 | <0.001 |
| Peripheral vascular disease | 0.984 | 0.590 | 1.639 | 0.950 |
| Cerebrovascular disease | 1.125 | 0.703 | 1.801 | 0.623 |
| Dementia | 1.265 | 0.780 | 2.052 | 0.340 |
| Chronic lung disease | 1.904 | 1.269 | 2.856 | 0.002 |
| Connective tissue disease | 1.597 | 0.950 | 2.684 | 0.077 |
| Diabetes | 1.370 | 0.942 | 1.993 | 0.099 |
| Chronic kidney disease | 1.425 | 0.934 | 2.173 | 0.100 |
| Other cancer | 1.097 | 0.676 | 1.778 | 0.708 |
| Metastatic cancer | 5.181 | 2.582 | 10.396 | <0.001 |
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Hernández Puentes, J.S.; Bastidas, A.R.; Tuta Quintero, E.A.; Acosta Otero, J.D.; Leyton Franco, V.; Castro Córdoba, J.D.; López Nuñez, L.M.; Lenhardt Guaqueta, I.; Mora Vega, A.; Martínez Sáenz, P.S.; et al. Positive Airway Pressure Therapies and Oxygen Therapy in Obstructive Sleep Apnea (OSA): 5-Year Survival. J. Clin. Med. 2025, 14, 8647. https://doi.org/10.3390/jcm14248647
Hernández Puentes JS, Bastidas AR, Tuta Quintero EA, Acosta Otero JD, Leyton Franco V, Castro Córdoba JD, López Nuñez LM, Lenhardt Guaqueta I, Mora Vega A, Martínez Sáenz PS, et al. Positive Airway Pressure Therapies and Oxygen Therapy in Obstructive Sleep Apnea (OSA): 5-Year Survival. Journal of Clinical Medicine. 2025; 14(24):8647. https://doi.org/10.3390/jcm14248647
Chicago/Turabian StyleHernández Puentes, Juan Sebastian, Alirio Rodrigo Bastidas, Eduardo Andres Tuta Quintero, Juan David Acosta Otero, Valeria Leyton Franco, Juan Diego Castro Córdoba, Lina María López Nuñez, Isabella Lenhardt Guaqueta, Alejandra Mora Vega, Paola Stefanny Martínez Sáenz, and et al. 2025. "Positive Airway Pressure Therapies and Oxygen Therapy in Obstructive Sleep Apnea (OSA): 5-Year Survival" Journal of Clinical Medicine 14, no. 24: 8647. https://doi.org/10.3390/jcm14248647
APA StyleHernández Puentes, J. S., Bastidas, A. R., Tuta Quintero, E. A., Acosta Otero, J. D., Leyton Franco, V., Castro Córdoba, J. D., López Nuñez, L. M., Lenhardt Guaqueta, I., Mora Vega, A., Martínez Sáenz, P. S., Faizal Gomez, C. K., Vaca Espinosa, M. C., Cardona Molina, C. F., Diaz Romero, G., & Rubio Noel, A. J. (2025). Positive Airway Pressure Therapies and Oxygen Therapy in Obstructive Sleep Apnea (OSA): 5-Year Survival. Journal of Clinical Medicine, 14(24), 8647. https://doi.org/10.3390/jcm14248647

