Cardiovascular and metabolic effects of CPAP in obese males with OSA

Abstract

Obstructive sleep apnoea is associated with increased blood pressure and other features of the metabolic syndrome. The aim of the present study was to determine the relative effectiveness of continuous positive airway pressure (CPAP) in modifying these outcomes.A randomised placebo-controlled blinded crossover trial comparing cardiovascular and metabolic outcomes after 6 weeks of therapeutic and sham CPAP was performed in 34 CPAPnaïve patients (mean¡SD body mass and respiratory disturbance indices were 36.1¡7.6 and 39.7¡13.8, respectively).Mean waking systolic and diastolic blood pressure fell by 6.7 and 4.9 mmHg, respectively, when compared with sham CPAP. No change was observed in glucose, lipids, insulin resistance or the proportion of patients with metabolic syndrome. In CPAP-compliant patients the fall in blood pressure was greater and the baroreceptor sensitivity improved significantly but no metabolic variable changed.In obese Caucasians with untreated obstructive sleep apnoea, continuous positive airways pressure can improve baroreceptor responsiveness and reduce waking blood pressure within 6 weeks, but this treatment period was insufficient to modify insulin resistance or change the metabolic profile. The mechanisms underlying this difference in the time course of blood pressure and metabolic response to continuous positive airway pressure in obstructive sleep apnoea requires further exploration.

Effects of long-term continuous positive airway pressure on body composition and IGF1

“…Our study was primarily focused on changes in BC. We thus did not record changes in other clinically important measures such as blood pressure, which has been shown to decrease in several trials (69)(70)(71). Finally, using a prepost design, we were able to detect changes within specific age categories only.…”

Heart rate recovery in obstructive sleep apnea: scientific toy or clinical tool?

“…It is possible that by an association with the metabolic changes hs-CRP was related to HRR-1 in the present study. However, in an uncontrolled study we had also shown that in patients with severe OSA, HRR is improved by CPAP [11], while recent studies on the effects of CPAP on hs-CRP and insulin resistance have been neutral [12,13]. Thus, the relationship between HRR-1 and hs-CRP seems to be more complicated and remains to be elucidated.…”

Screening for obstructive sleep apnoea in obesity and diabetes – potential for future approaches

“…An interventional study by Coughlin et al [40] found no significant change in weight, body fat, insulin resistance or lipid profiles with CPAP treatment as opposed to sham CPAP therapy. Nevertheless, there were improvements in blood pressure control following CPAP intervention.…”