All of these data suggest that CPAP should exert a favorable effect on patients with OSA, and in particular, patients with OSA and cardiovascular disease. However, unequivocal data showing long-term benefits with cardiovascular endpoints are still lacking. So, in turn, the question of which patients with OSA that will derive benefit from treatment remains somewhat controversial. Practice parameters developed by the American Academy of Sleep Medicine and published in 2006 describe the indications for PAP therapy; the main indications are described in this section (43).
In North America, OSA is remarkably prevalent in the general population, with studies showing an estimated 20% of adults with mild to asymptomatic disease and at least 5% of adults with significant disease (44). The prevalence has been estimated to be as high as 30% to 50% in some at-risk patient populations (27,45,46).
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