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Sleep and Breathing

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01-03-2021 | Sleep Apnea | Sleep Breathing Physiology and Disorders • Original Article

Effect of CPAP therapy on nocturnal blood pressure fluctuations, nocturnal blood pressure, and arterial stiffness in patients with coexisting cardiovascular diseases and obstructive sleep apnea

Authors: Frauke Picard, Petroula Panagiotidou, Laura Weinig, Maximilian Steffen, Anne-Beke Tammen, Rolf Michael Klein

Published in: Sleep and Breathing | Issue 1/2021

Abstract

Purpose

Obstructive sleep apnea (OSA) can induce dramatic nocturnal blood pressure fluctuations (NBPFs) and can be associated with nocturnal hypertension and arterial stiffness. We investigated the effect of short- and long-term continuous positive airway pressure (CPAP) therapy on NBPFs, nocturnal blood pressure (BP), and arterial stiffness in patients with coexisting cardiovascular diseases (CVD) and OSA (CVD/OSA).

Methods

Of 86 patients with CVD, 58 also had OSA, while 28 without OSA served as controls. Nighttime BP was measured continuously using pulse transit time (PTT) and arterial stiffness was measured with pulse wave velocity (PWV). A NBPF was defined as systolic BP elevation > 12 mmHg in a 30 s interval of sleep. All measurements were conducted at baseline, after the first night of CPAP, and after 6 months of CPAP therapy.

Results

In CVD/OSA patients, we observed significantly more frequent NBPFs (p < 0.001) compared with controls. CPAP therapy decreased the frequency of NBPFs (p < 0.001), the maximum systolic BP by 9 mmHg (p = 0.021), and PWV (p < 0.001) even after the first night. After long-term CPAP therapy, there was an additional decrease in average nocturnal systolic BP by 10 mmHg (p = 0.039).

Conclusions

Our findings demonstrate that CPAP therapy reduces NBPFs, nocturnal BP, and arterial stiffness in CVD/OSA patients. This effect was demonstrable after the first night of CPAP and grew more robust after 6 months of CPAP therapy.

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Title: Effect of CPAP therapy on nocturnal blood pressure fluctuations, nocturnal blood pressure, and arterial stiffness in patients with coexisting cardiovascular diseases and obstructive sleep apnea
Authors: Frauke Picard
Petroula Panagiotidou
Laura Weinig
Maximilian Steffen
Anne-Beke Tammen
Rolf Michael Klein
Publication date: 01-03-2021
Publisher: Springer International Publishing
Keywords: Sleep Apnea
Polysomnography
Published in: Sleep and Breathing / Issue 1/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-020-02075-4

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