THU413 Does Continuous Positive Airway Pressure Affect Bone Loss Process In The Population Of Sleep Apnea?
Authors: Chen Yi-Ju , Suresh Annu , Haile Selam , Perciuleac Zinaida , Soni Bosky , Velazquez Adan Cuevas , Amirian Aslan , Udeh Chinyere , Sangha Lillian , Ravichander Benjamin , Aljassani Khaldoon , Joshi Renu , Atrash Anas , Ramesh Navitha , Cruz Joanna Sta , Al-saadi Samer 
Published: October 2023

Abstract
Disclosure: Y. Chen: None. A. Suresh: None. S. Haile: None. Z. Perciuleac: None. B. Soni: None. A. Cuevas Velazquez: None. A. Amirian: None. C. Udeh: None. L. Sangha: None. B. Ravichander: None. K. Aljassani: None. R. Joshi: None. A. Atrash: None. N. Ramesh: None. J. Sta. Cruz: None. S. Al-saadi: None.
Introduction: Patients with obstructive sleep apnea (OSA) were reported to have higher risk of developing osteoporosis or increased bone loss. One of the theories suggested nocturnal hypoxia led to imbalanced osteoclastic activity and contributed to bone loss. Continuous Positive Airway Pressure (CPAP) is the first-line treatment for OSA, which improves airway obstruction and limits hypoxia. This study attempts to evaluate if compliant with CPAP therapy reduces bone loss. Methods: This retrospective study included patients who visited UPMC Central Pa. sleep medicine clinic from January 2010 to October 2022 with diagnosis of OSA and have at least two dual-energy X-ray absorptiometry (DEXA) after the OSA diagnosis. Patients’ records of CPAP usage on two databases, Respironics and Resmed, were used to assess the compliance of the therapy. The definition of compliance is average usage of 4hrs/night; frequency of use being 70% or above. Patient demographics, CPAP compliance, bone mineral density (BMD) and T-scores of two DEXAs were obtained. All data after diagnosis of active malignancy, hyperparathyroidism, end stage renal disease, or after patient received osteoporosis pharmacological treatment are excluded. Annual change of BMD was calculated with the difference of BMD between the two DEXA scans divided by the study interval. Two-sample t-test and chi-square test were used for analysis. Results: 265 patients were included for analysis, with 254 female (95.8%), 92.1% Caucasian, mean age 68.3 years old, mean BMI 36.7kg/m2. 165 patients were compliant and 100 were non-compliant. The two groups were identical on demographic data including age, sex, ethnicities. The median of annual BMD changes at L-spine, left femur neck, left femur total, and left radius were 0.003, −0.003, −0.002, −0.002 g/cm2 respectively in compliant group and 0.003, 0, −0.006, −0.002 g/ cm2 in non-compliant group. The annual changes of T-scores were 0, −0.043, 0, −0.036 for the compliant group and 0, 0, −0.051, −0.034 for non-compliant group. No significant within-group or between-group difference in annual bone density reduction on BMD or T-score was noted in our analysis. Discussions: Our study did not reveal the benefit of treating OSA on bone loss. Small sample size could be the leading factor for the limited effect size. Retrospective study design also restricted our study population to predominantly postmenopausal Caucasian female. Further adjustments for possible confounding factors including BMI and age might be beneficial. Future study with prospective design, larger sample size, and diverse population is encouraged to discover the effect of CPAP therapy on BMD preservation.
Presentation: Thursday, June 15, 2023