Beneficial response of blood pressure to short-term continuous positive airway pressure in Chinese patients with obstructive sleep apnea-hypopnea syndrome

Wang, Xiao; Qiu, Jian; Wang, Yufeng; Cai, Zechuan; Lü, Xingcai; Li, Taoping

doi:10.1097/mbp.0000000000000324

Cited by 7 publications

(3 citation statements)

References 39 publications

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“…For example, positive effects of PAP therapy on quality-adjusted life years (QALY) has been shown in Brazil. [68][69][70][71][72] Analysis of OSA patients with associated comorbidities may help better define groups requiring increased care. A study of patients with ischaemic strokes and OSA by home sleep testing found three phenotype clusters, with one cluster having severe OSA and higher prevalence of medical comorbidities.…”

Section: Global Outcomes and Osamentioning

confidence: 99%

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Global burden of sleep‐disordered breathing and its implications

et al. 2020

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One‐seventh of the world's adult population, or approximately one billion people, are estimated to have OSA. Over the past four decades, obesity, the main risk factor for OSA, has risen in striking proportion worldwide. In the past 5 years, the WHO estimates global obesity to affect almost two billion adults. A second major risk factor for OSA is advanced age. As the prevalence of the ageing population and obesity increases, the vulnerability towards having OSA increases. In addition to these traditional OSA risk factors, studies of the global population reveal select contributing features and phenotypes, including extreme phenotypes and symptom clusters that deserve further examination. Untreated OSA is associated with significant comorbidities and mortality. These represent a tremendous threat to the individual and global health. Beyond the personal toll, the economic costs of OSA are far‐reaching, affecting the individual, family and society directly and indirectly, in terms of productivity and public safety. A better understanding of the pathophysiology, individual and ethnic similarities and differences is needed to better facilitate management of this chronic disease. In some countries, measures of the OSA disease burden are sparse. As the global burden of OSA and its associated comorbidities are projected to further increase, the infrastructure to diagnose and manage OSA will need to adapt. The use of novel approaches (electronic health records and artificial intelligence) to stratify risk, diagnose and affect treatment are necessary. Together, a unified multi‐disciplinary, multi‐organizational, global approach will be needed to manage this disease.

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Section: Global Outcomes and Osamentioning

confidence: 99%

“…Limited data exist on OSA‐associated disorders and the effects of treatment in varying populations. For example, positive effects of PAP therapy on quality‐adjusted life years (QALY) has been shown in Brazil …”

Section: Global Outcomes and Osamentioning

confidence: 99%

Global burden of sleep‐disordered breathing and its implications

et al. 2020

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“…For instance, while CPAP therapy has been shown to successfully decrease both nocturnal and diurnal mean BP after only 1 week of intervention (Dimsdale et al., 2000), a similar acute approach succeeded in decreasing only nocturnal variations of systolic and diastolic BP, as opposed to daytime ones in moderate or severe OSA patients (Dursunoğlu et al., 2005). In other studies CPAP failed to significantly reduce BP after 4 (Campos‐Rodrigues et al., 2006) and 6 weeks (Barbé et al., 2001), while promoting only a small BP reduction after 30 days (Wang et al., 2018).…”

Section: Discussionmentioning

confidence: 92%

Effects of short‐term aerobic training versus CPAP therapy on heart rate variability in moderate to severe OSA patients

et al. 2021

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We compared the effects of 2‐month CPAP or exercise training (ET) therapies on the autonomic balance in moderate to severe obstructive sleep apnea (OSA) through heart rate variability (HRV) analysis. Thirty‐nine OSA patients were divided into CPAP (n = 18) and ET (n = 21) groups, being further split into hypertensive and non‐hypertensive subgroups. All patients were submitted to continuous ECG recordings for HRV analysis. Hemodynamic parameters were recorded by oscillometry. Excessive daytime sleepiness and sleep quality were assessed through the Epworth Sleepiness Scale and the Pittsburgh questionnaire, respectively. ET decreased systolic arterial pressure in hypertensive and non‐hypertensive participants when compared to baseline values, whereas diastolic arterial pressure was decreased only in non‐hypertensive ones. CPAP had no effect over hemodynamic parameters in either subgroup. ET significantly increased the HRV parameters SDNN and pNN50 in non‐hypertensive participants, while reducing the LF/HF ratio in both subgroups. CPAP significantly decreased SDNN in both subgroups. ET significantly decreased excessive daytime sleepiness in both subgroups, but did not affect sleep quality. CPAP significantly improved sleep quality in both subgroups, although global scores were still those of poor sleepers, while excessive daytime sleepiness was normalized only in hypertensive patients. In conclusion, while short‐term ET modulated different HRV parameters, leading to a predominant vagal tone in the cardiac sympathovagal balance and decreasing blood pressure in moderate to severe OSA, short‐term CPAP had next to no effect in these parameters. We believe ET should be considered as an adjunct interventional strategy in the conservative management of hypertensive or non‐hypertensive OSA patients.

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