For how we live.
A systematic review of longitudinal MRI after CPAP for sleep apnoea finds changes reported in every domain and reproducible effects in none — a useful map of what the evidence does not yet show.
After four weeks, the comorbid-insomnia group's blood pressure fell 20 points more than the apnea-only group. The finding flips the usual framing of COMISA as simply a worse-outcomes phenotype.
Pooling eight trials, oral appliances left nearly 12 more breathing events per hour than CPAP. But the trials disagreed with each other so much that the researchers say that number itself should be read with caution.
Nearly twice as many CPAP-treated patients saw their HFpEF-like markers improve at one year compared with those who went untreated — in a population sleep specialists have historically deprioritized for treatment.
Both machine types cut breathing interruptions equally well in a 108-patient study. But auto-adjusting PAP's constantly shifting pressure came with more time awake and less total sleep on night one.
Researchers deliberately withdrew CPAP for three nights to simulate untreated sleep apnea, then tested propranolol against placebo. It slowed the heart-rate surges tied to apnea events, at the price of lighter sleep.
Matched against a comparator diabetes drug, incretin agonists were associated with an 8% lower rate of CPAP procedures — alongside a 32% lower mortality that should make readers cautious.
A national insurance-claims analysis found long-term adherence far below what trial populations suggest, despite universal coverage and strict usage monitoring. The monitoring may be part of the problem.