Pulse wave analysis in a pilot randomised controlled trial of auto-adjusting and continuous positive airway pressure for obstructive sleep apnoea

Bakker, Jessie P.; Campbell, Angela; Neill, Alister

doi:10.1007/s11325-010-0385-9

Cited by 15 publications

(12 citation statements)

References 42 publications

(45 reference statements)

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“…In the study by Bakker et al . significant decrease in AIx was observed after continuous positive airway pressure (CPAP) and auto‐CPAP therapy . In the present study, although AIx was higher in AHI high patients, it did not reach statistical significance.…”

Section: Discussioncontrasting

confidence: 78%

“…Non‐invasive measurements of arterial stiffness including the augmentation index and central blood pressure have been used to assess the cardiovascular health of patients with obstructive sleep apnoea, a well‐established independent risk factor of cardiovascular disease . In a study by Jones et al .…”

Section: Discussionmentioning

confidence: 99%

“…However, future research is warranted to provide more robust information on the reason of this relationship between aortic elastic parameters and the severity of OSA. Non-invasive measurements of arterial stiffness including the augmentation index and central blood pressure have been used to assess the cardiovascular health of patients with obstructive sleep apnoea, a wellestablished independent risk factor of cardiovascular disease (29). In a study by Jones et al where 20 patients with OSA compared with controls, negative correlation between aortic distensibility and OSA was observed.…”

Section: Discussionmentioning

confidence: 99%

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Aortic stiffness increases in proportion to the severity of apnoea–hypopnea index in patients with obstructive sleep apnoea syndrome

Çörtük

Akyol

Baykan

et al. 2014

Clinical Respiratory J

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Aortic stiffness increases in proportion to the severity of apnoea–hypopnea index in patients with obstructive sleep apnoea syndrome

Çörtük

Akyol

Baykan

et al. 2014

Clinical Respiratory J

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“…Bakker et al . () investigated the effects of continuous and auto‐adjusted positive airway pressure on 12 severely obese patients, but did not study patients of similar BMI without OSA (Bakker et al ., ).…”

Section: Introductionmentioning

confidence: 99%

“…Yim-Yeh et al (2010) investigated the effects of age and OSA on vascular function in a cohort with a mean BMI of 37 kg m À2 (Yim-Yeh et al, 2010). Bakker et al (2011) investigated the effects of continuous and auto-adjusted positive airway pressure on 12 severely obese patients, but did not study patients of similar BMI without OSA (Bakker et al, 2011).…”

mentioning

confidence: 99%

Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity

Seetho

Parker

Craig

et al. 2014

Journal of Sleep Research

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Obstructive sleep apnea is associated with obesity and metabolic syndrome, leading to greater cardiovascular risk. Severely obese patients with obstructive sleep apnea may still be at risk of adverse health outcomes, even without previous cardiovascular disease. Pulse wave analysis non-invasively measures peripheral pulse waveforms and derives measures of haemodynamic status, including arterial stiffness, augmentation pressure and subendocardial viability ratio. We hypothesized that the presence of obstructive sleep apnea in severe obesity, even in the absence of an antecedent history of cardiovascular disease, would affect measurements derived from pulse wave analysis. Seventy-two severely obese adult subjects [obstructive sleep apnea 47 (body mass index 42 AE 7 kg m À2), without obstructive sleep apnea (non-OSA) 25 (body mass index 40 AE 5 kg m À2)] were characterised using anthropo-metric, respiratory and cardio-metabolic parameters. Groups were similar in age, body mass index and gender. More subjects with obstructive sleep apnea had metabolic syndrome [obstructive sleep apnea 60%, without obstructive sleep apnea (non-OSA) 12%]. Those with obstructive sleep apnea had greater arterial stiffness, augmentation pressure and decreased subendocardial viability ratio (all P < 0.001), with significantly higher systolic (P = 0.003), diastolic (P = 0.04) and mean arterial pressures (P = 0.004) than patients without obstructive sleep apnea (non-OSA). Arterial stiffness correlated with mean arterial blood pressure (P = 0.003) and obstructive sleep apnea severity (apnea-hypopnea index; P < 0.001). apnea-hypopnea index significantly predicted arterial stiffness in multiple regression analysis, but components of the metabolic syndrome did not. Thus, patients with obstructive sleep apnea with severe obesity have increased arterial stiffness that may potentially influence cardiovascular risk independently of metabolic abnormalities. The presence of obstructive sleep apnea in severe obesity identifies a group at high cardiovascular risk; clinicians should ensure that risk factors are managed appropriately in this group whether or not treatment of obstructive sleep apnea is offered or accepted by patients. IN TROD UCTI ON Obstructive sleep apnea (OSA) is a common condition, with prevalence in middle-aged men and women at 4% and 2%, respectively (Young et al., 1993). Obesity is an important risk factor for OSA, with prevalence estimates in severe obesity between 40% and 90% (Schwartz et al., 2008). OSA is characterised by repetitive intermittent hypoxia, periodic arousals and sleep fragmentation, with cardiovascular and metabolic sequelae. Randomised trials have shown that OSA treatment with continuous positive airway pressure (CPAP) can improve hypertension and atherosclerosis (Drager et al., ª 2014 European Sleep Research Society 700

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Cardiovascular Function in Obstructive Sleep Apnea Patients with Controlled Hypertension

Kostrzewska

Grabicki

Piorunek

et al. 2020

Advances in Experimental Medicine and Biology

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Pulse wave analysis in a pilot randomised controlled trial of auto-adjusting and continuous positive airway pressure for obstructive sleep apnoea

Abstract: The large effect size evident when comparing the AIx following CPAP and APAP indicates the need to perform an adequately powered trial in order to determine if APAP improves arterial stiffness to the same extent as CPAP.

Cited by 15 publications

References 42 publications

Aortic stiffness increases in proportion to the severity of apnoea–hypopnea index in patients with obstructive sleep apnoea syndrome

Aortic stiffness increases in proportion to the severity of apnoea–hypopnea index in patients with obstructive sleep apnoea syndrome

Obstructive sleep apnea is associated with increased arterial stiffness in severe obesity

Cardiovascular Function in Obstructive Sleep Apnea Patients with Controlled Hypertension

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