Should “mild” sleep apnea be treated?

Have you had a sleep study and were told it showed “mild” sleep apnea, but treatment wasn’t necessary?  This very issue is often debated within the sleep community.  The presumption among some practitioners and patients is that the perceived “burden” of CPAP probably outweighs the benefit of treatment.


Sleep specialists are well aware that even patient’s with mild sleep apnea, usually defined by an apnea index of less than 15, can have a benefit from treatment with CPAP.  A recent study gives evidence for this.

Published in the journal, Thorax, the MOSAIC randomized trial sought to determine the effect of CPAP treatment on patient’s with mild OSA.  The determined effect was based on questionnaires regarding daytime sleepiness and function, as well as a variety of physiologic parameters, including blood pressure, blood sugar control, and cholesterol that signify vascular risk.

At 6 months, the patient’s were reassessed.  Even with a median CPAP usage of only about 2.5 hours per night, there was a significant improvement in daytime sleepiness scores.  There was no detected effect on vascular risk.  An obvious limitation of the study is that followup was only at 6 months, when the average usage of CPAP was still suboptimal.

Nevertheless, this study brings up a number of important points:

  • First, CPAP works!  The prospect of wearing a mask on your face to sleep may sound daunting.  With an experienced sleep specialist helping out, most patients can make get through those first few weeks.  They can actually learn to love it for the simple reason that it can make you feel better.  There are literally hundreds of different types of masks and one can usually be found that’s comfortable for you.  As this study shows, even patients with “mild” OSA can get a benefit from using it.
  • Second, health benefits from using CPAP are real.  Though the effect of CPAP on blood pressure, cardiovascular, and cerebrovascular  risk in mild OSA is modest, the risk reduction in people with moderate to severe OSA is very significant.

The important point here is that if you have symptoms of sleep apnea, such as excessive daytime sleepiness or snoring, and your sleep study shows only “mild” disease, treatment can work. 


Find out more:

Sleep disorders in general,

Monmouth’s Sleep Lab,

Monmouth Neuroscience Institute’s Comprehensive Sleep Medicine Program.


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