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Editorials |

Could Vitamins Be Helpful to Patients With Sleep Apnea?

Judy L. Shih, MD, PhD; Atul Malhotra, MD, FCCP
Author and Funding Information

From the Department of Medicine (Dr Shih) and the Department of Pulmonary, Critical Care, and Sleep Medicine (Dr Malhotra), Brigham and Women’s Hospital and Harvard Medical School.

Correspondence to: Judy L. Shih, MD, PhD, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115; e-mail: Judy_Shih@vmed.org


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Malhotra has received consulting and/or research income from Philips, Sepracor, Pfizer, Merck, Apnex, Itamar, Cephalon, Sleep Group Solutions, Sleep Health Centers, Medtronic, and Ethicon. Dr Shih has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(2):237-238. doi:10.1378/chest.10-2017
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Extract

Considerable evidence supports the link between sleep disturbance and cardiovascular disease.1 Obstructive sleep apnea (OSA), in particular, is associated with cardiovascular morbidity and mortality,2 and thus, one might reason that effective treatment of OSA represents an important target for improving cardiovascular risk.

Should OSA then be actively diagnosed and treated in all patients with cardiovascular risk? To make such a recommendation, large-scale randomized controlled trials (RCTs) demonstrating the benefits of OSA treatment with respect to cardiovascular outcomes would be necessary. However, the design of such OSA RCTs assessing hard cardiac end points (eg, cardiac events and death) is challenging because of ethical and logistic considerations. Randomizing patients with severe symptomatic OSA to long periods off therapy may be problematic when considerable evidence shows symptomatic benefit of nasal continuous positive airway pressure (CPAP).3 An alternative would be to design shorter-term RCTs using surrogate biomarkers of cardiovascular events as end points.

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