Curious what folks think about this article

[remstarcpap]

https://www.medscape.com/viewarticle/999441?src= CPAP Oversells and Underperforms

"For the majority of patients, hypopneas constitute the majority of the AHI. … But no one, including the AASM, knows what a hypopnea is."

"CPAP did lead to significant 24-hour blood pressure reduction, but guess how large it was? For systolic blood pressure, it was 1.5 mm Hg; for diastolic pressure, it was 1.6 mm Hg. That's it."

It's an interesting article, and I'd be curious what folks think about it.

[Pugsy]

I'd be curious what folks think about it.

I think it proves a thought I have had for over 40 years about doctors....just because you got fancy letters after your name doesn't mean you can't be a friggin idiot.
He cherry picked data to fit his idea. Anyone can do that.

[ChicagoGranny]

Using the term "pressure pushers" revealed his extreme bias. Very unprofessional. Ignore.

[amenite]

I think the good doctor has never experienced the condition himself. If only there were an OSA simulator, like those goggles they put on people and make them drive like a drunk.

[lazarus]

The article makes some valid points but unfortunately does so in a way that earns clicks and can mislead.

CPAP does one thing and does it well. It doesn't so much solve any health problems all on its own, though--it only puts you in a position to be able to start solving them.

No metabolic-related health problems can be solved until you can sleep and breathe. Nevertheless, once health problems have begun, more will need to be done to solve them completely than merely restoring the breathing and the sleep.

Those facts shouldn't be a knock against breathing and sleeping. But expectations do need to be reasonable in that patients will still need to put in the work for improving their health even after they can breathe and sleep again from vigilant, optimized CPAP use.

[Tec5]

I think it proves a thought I have had for over 40 years about doctors....just because you got fancy letters after your name doesn't mean you can't be a friggin idiot.

A similar article published by sleep science is also food for thought:

The most important shortcoming of AHI is that it indicates the number of episodes of events only and does not factor in the duration or depth of abnormal respiratory events, i.e., the severity of oxygen desaturation associated with apnea or hypopnea. When the depth and duration of apnea or hypopnea increase, the number of respiratory events happening in an hour may paradoxically fall contrary to the increased severity of the episodes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8889990/

While not disputing the value of CPAP therapy, it does suggest that focus on AHI feedback data from home devices may provide the patient & DRs with a false sense of accomplishment/efficacy.