CPAP and Cardiovascular Risk; Benefit for Some But Not All

CPAP is considered the “gold standard” treatment for obstructive sleep apnea (OSA). But is it right for everyone?

When it comes to reducing the incidence of cardiovascular disease, the answer may be no.

Researchers from Mount Sinai reached that conclusion after using a machine learning algorithm to develop a model that predicts how CPAP may affect an individual’s cardiovascular health based on sleep and health data. The model considered more than 100 predictors from sleep and health data gathered during the Sleep Apnea Cardiovascular Endpoints study, which involved more than 2,600 participants across seven countries and compared patients who used CPAP with those receiving usual care.

Twenty-three key baseline features, including prior medical conditions and smoking status, ended up in the analysis model.

The model identified two subgroups, one that experienced a 100-fold improvement in future cardiac risk when randomized to CPAP over usual care and one that experienced a 100-fold increase in cardiovascular disease outcomes — including recurrent strokes and heart attacks — when randomized to CPAP over usual care.

“Our findings represent a significant advancement in personalized medicine, moving away from a one-size-fits-all strategy in the treatment of obstructive sleep apnea,” said study author Neomi A. Shah, MD, MPH, MSC, from the Icahn School of Medicine at Mount Sinai. “This underscores the value of new data-driven approaches like our model to assist clinicians in making informed decisions about CPAP treatment recommendations, enhancing personalized care to meet the individual needs of every patient.”

The study was supported by grants from the Stony-Wold Herbert Fund, the American Academy of Sleep Medicine Foundation, and the National Heart, Lung and Blood Institute. It was published by Communications Medicine. 

Highlighted in RC Buzz April 27, 2026