Nocturnal blood pressure and nocturnal blood pressure fluctuations: the effect of short-term CPAP therapy and their association with the severity of obstructive sleep apnea

Picard, Frauke; Panagiotidou, Petroula; Tammen, Anne-Beke; Wolf-Pütz, Anamaria; Steffen, Maximilian; Gerhardy, Hanno Julian; Waßenberg, Sebastian; Klein, Rolf Michael

doi:10.5664/jcsm.9564

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…The American Academy of Sleep Medicine guidelines note the importance of CPAP therapy for patients with OSA [1]. Long-term CPAP therapy has also been reported to have antihypertensive effects [8,[21][22][23][24]. Our results showed that CPAP therapy significantly reduced SBP, DBP, and NBPFs during REM and non-REM sleep.…”

Section: Discussionsupporting

confidence: 56%

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Effects of continuous positive airway pressure therapy on nocturnal blood pressure fluctuation patterns in patients with obstructive sleep apnea

Kumagai

Sawatari

Hoshino

et al. 2022

Preprint

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Purpose: Continuous positive airway pressure (CPAP) therapy is a well-established treatment for obstructive sleep apnea (OSA). In this study, we aimed to assess the effects of CPAP therapy on nocturnal blood pressure (NBP) fluctuations (NBPFs) during rapid eye movement (REM) and non-REM sleep, and the NBPF patterns in patients with OSA. Methods: This retrospective study included 34 patients with moderate-to-severe OSA who underwent polysomnography using pulse transit time pre-CPAP therapy and 3–6 months post-CPAP therapy. We investigated NBP and the frequency of NBPFs in REM and non-REM sleep, as well as changes in NBPFpatterns post-CPAP therapy. Results: The apnea-hypopnea index (AHI), arousal index, systolic NBP, diastolic NBP, diurnal systolic BP (SBP), diastolic BP (DBP), and frequency of NBPFs in REM and non-REM sleep were significantly reduced post-CPAP therapy (all p < 0.01). A higher pre-CPAP AHI was associated with a reduction in diurnal SBP, systolic NBP, and NBPFs post-CPAP (r = 0.32, p = 0.028; r = 0.40, p = 0.019; and r = 0.51, p = 0.002; respectively). However, 58.8% of the patients showed no NBPF pattern change with CPAP therapy. Conclusion: In REM and non-REM sleep, almost all sleep-related parameters, NBP, and frequency of NBPFs significantly improved post-CPAP therapy, whereas NBPF patterns showed varying changes 3–6 months post-CPAP therapy. These results suggest that factors other than OSA influence NBPF pattern changes.

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Section: Discussionsupporting

confidence: 56%

“…While CPAP therapy has been shown to be effective against NBPFs from the first night of use [22], our findings suggest that the positive effects on NBPFs continue for 3-6 months after CPAP. High SBP and DBP are known to increase CVD risk [31].…”

Section: Discussioncontrasting

confidence: 52%

Effects of continuous positive airway pressure therapy on nocturnal blood pressure fluctuation patterns in patients with obstructive sleep apnea

Kumagai

Sawatari

Hoshino

et al. 2022

Preprint

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“…This is consistent with the studies done in China [ 42 ] and Nigeria [ 53 ]. The possible justification could be that having excess body weight causes obstructive sleep apnea (difficulty of breathing during sleep), hence insufficient sleep due to breathing difficulties enhances poor sleep quality [ 54 – 57 ].…”

Section: Discussionmentioning

confidence: 99%

Sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia

et al. 2022

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Introduction Sleep plays an essential role in every individual’s life since it contributes greatly to their well-being and health. Poor sleep quality is one of the most common consequences of hypertension (HTN), which is a leading public health problem. In Ethiopia, it is the main health concern among hypertension patients. Thus, in the study area, there is limited information regarding the investigation of sleep quality among hypertension patients. Therefore, this study aimed to assess sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted among adult HTN patients from March 15/2021 to May 15/2021 in Northwest Amhara Regional State Referral Hospitals. A systematic random sampling method was used to select the study participants. A face-to-face interviewer-administered questionnaire with chart review was used. The Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality was used in this study. A binary logistic regression was used to see the association between dependent and independent variables. Variables having a p-value < 0.05 with a 95% CI were considered statistically significant in the multivariable logistic regression analysis. Results In this study, 563 hypertensive patients were included, with a response rate of 96.9%. The overall prevalence of poor sleep quality was 37.7% (95% CI: 33.4%–41.6%). Female gender (AOR = 2.55, 95% CI: 1.55–4.18), age ≥ 65 years (AOR = 4.07, 95% CI: 2.07–7.97), overweight (BMI) ≥ 25 kg/m2 (AOR = 1.68, 95% CI: 1.06–2.65), WHO stage II hypertension (AOR = 1.78, 95% CI:1.01–3.12), poor physical activity (AOR = 2.39, 95% CI:1.41–4.05), participants who had depression (AOR = 2.03,95% CI:1.24–3.34) and participants who had anxiety (AOR = 1.89, 95% CI: 1.16–3.03) were factors associated with poor sleep quality. Conclusions In this study, more than one-third of the study participants had poor sleep quality. Female gender, age ≥ 65 years, overweight (BMI) ≥ 25 kg/m2, stage II hypertension, physical inactivity, depression, and anxiety were all associated with poor sleep quality. Managing depression and anxiety disorders, encouraging physical activity, and providing health education about weight loss are all necessary for HTN patients.

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“…The AASM guidelines note the importance of CPAP therapy for patients with OSA [ 1 ]. Long-term CPAP therapy has antihypertensive effects [ 8 , 23 , 24 , 25 , 26 ]. In this study, we revealed that CPAP therapy for 3–6 months significantly reduced SBP, DBP, and NBPFs during REM and non-REM sleep.…”

Section: Discussionmentioning

confidence: 99%

Effects of Continuous Positive Airway Pressure Therapy on Nocturnal Blood Pressure Fluctuation Patterns in Patients with Obstructive Sleep Apnea

Kumagai

Sawatari

Hoshino

et al. 2022

IJERPH

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This retrospective study was designed to evaluate the effects of continuous positive airway pressure (CPAP) therapy, a well-established treatment for obstructive sleep apnea (OSA), on nocturnal blood pressure fluctuations (NBPFs) during rapid eye movement (REM) and non-REM sleep, and to evaluate the NBPF patterns in patients with OSA. We included 34 patients with moderate-to-severe OSA who underwent polysomnography using pulse transit time before and at 3–6 months after CPAP therapy. Nocturnal BP and NBPF frequency in REM and non-REM sleep were investigated, as well as NBPF pattern changes after receiving CPAP therapy. CPAP therapy resulted in significant reductions in the apnea–hypopnea index (AHI), arousal index, nocturnal systolic and diastolic BP, and NBPF frequency in REM and non-REM sleep (all p < 0.01). A higher AHI before CPAP resulted in lower nocturnal systolic BP (r = 0.40, p = 0.019) and NBPFs (r = 0.51, p = 0.002) after CPAP. However, 58.8% of patients showed no change in NBPF patterns with CPAP therapy. CPAP therapy significantly improved almost all sleep-related parameters, nocturnal BP, and NBPF frequency in REM and non-REM sleep periods, but NBPF patterns showed various changes post-CPAP therapy. These results suggest that factors other than OSA influence changes in NBPF patterns.

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Nocturnal blood pressure and nocturnal blood pressure fluctuations: the effect of short-term CPAP therapy and their association with the severity of obstructive sleep apnea

Cited by 9 publications

References 33 publications

Effects of continuous positive airway pressure therapy on nocturnal blood pressure fluctuation patterns in patients with obstructive sleep apnea

Effects of continuous positive airway pressure therapy on nocturnal blood pressure fluctuation patterns in patients with obstructive sleep apnea

Sleep quality and associated factors among adult hypertensive patients attending a chronic follow up care clinic in northwest Amhara regional state referral hospitals, Northwest Ethiopia

Effects of Continuous Positive Airway Pressure Therapy on Nocturnal Blood Pressure Fluctuation Patterns in Patients with Obstructive Sleep Apnea

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