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Effect of CPAP on cardiovascular events in minimally symptomatic OSA: long-term follow-up of the MOSAIC randomised controlled trial
  1. Ivan Tang1,
  2. Chris D Turnbull2,3,
  3. Dushendree Sen2,
  4. Sonya Craig4,
  5. Malcolm Kohler5 and
  6. John R Stradling3
  1. 1Department of Anaesthesia and Intensive Care, Milton Keynes University Hospital, Milton Keynes, UK
  2. 2Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
  3. 3NIHR Biomedical Research Centre Oxford, University of Oxford, Oxford, Oxfordshire, UK
  4. 4Liverpool Sleep and Ventilation Centre, University Hospital Aintree, Liverpool, UK
  5. 5Centre for Interdisciplinary Sleep Research, University of Zurich, Zurich, Switzerland
  1. Correspondence to Dr Chris D Turnbull; christopher.turnbull{at}


The effect of continuous positive airway pressure (CPAP) on cardiovascular events is uncertain in minimally symptomatic obstructive sleep apnoea. Previous 2-year follow-up data from the Multicentre Obstructive Sleep Apnoea Intervention Cardiovascular (MOSAIC) trial showed a marginal reduction in cardiovascular events with CPAP therapy. We now present long-term MOSAIC study follow-up data. Median (first quartile, third quartile) follow-up was 5.0 (2.2, 5.0) and 3.7 (1.5, 5.0) years for CPAP and standard care, respectively. Compared to standard care, CPAP had no statistically significant effect on the risk of cardiovascular events (HR=0.83, p=0.54, 95% CI 0.46–1.51).

  • sleep apnoea
  • systemic disease and lungs

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  • IT and CDT are joint first authors.

  • Contributors SC, MK and JRS conceived the initial trial and were responsible for trial design. IT and DS were responsible for data collection. IT and CDT were responsible for data analysis, literature searches and preparing the first draft of the manuscript. All authors viewed, commented and took responsibility for the final manuscript.

  • Funding The British Heart Foundation—unrestricted project grant.

  • Competing interests JRS has done paid consulting work for Bayer and Resmed, outside of the scope of this work. CDT has done paid consulting work for Bayer, outside of the scope of this work.MK reports personal fees from Bayer, personal fees from Astra, personal fees from Boehringer, grants from Roche, grants and personal fees from GSK, personal fees from Novartis, personal fees from Philips Respironics, outside the submitted work.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available upon reasonable request including appropriate ethical approval. Qualified researchers may request access to patient level data and related study documents including the study protocol. Requests will be reviewed for scientific merit. Patient level data will be deidentified and study documents will be redacted to protect the privacy of trial participants. Please contact the corresponding author.

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