Effects of continuous positive airway pressure on blood pressure and daytime sleepiness in obstructive sleep apnea patients with coronary heart diseases under optimal medications

Feb 22, 2011Sleep & breathing = Schlaf & Atmung

Continuous positive airway pressure's effects on blood pressure and daytime sleepiness in sleep apnea patients with heart disease on proper medication

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Abstract

CPAP treatment for 1 month resulted in a significant reduction in morning diastolic blood pressure by 5.1 ± 6.5 mmHg in patients with coronary heart disease and obstructive sleep apnea.

Diastolic blood pressure decreased more in the CPAP group compared to the control group.
The CPAP group showed a notable improvement in daytime sleepiness as measured by the Epworth sleepiness scale.
No significant changes were observed in systolic blood pressure, heart rate, or quality of life between the two groups.
The findings suggest that CPAP may help manage blood pressure and sleepiness in patients with both obstructive sleep apnea and coronary heart disease.

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BACKGROUND: Continuous positive airway pressure (CPAP) is an effective therapy for obstructive sleep apnea (OSA). However, for patients who already have OSA and coronary heart diseases (CHD) with optimal medications, whether CPAP can reduce the blood pressure (BP) is not clear. This is a controlled study to evaluate the effects of CPAP on BP in Chinese cohorts with CHD under optimal medications.

METHODS: Twenty-four patients with CHD and moderate to severe OSA were treated with CPAP and standard care for 1 month. Twenty-four matched control patients were only treated with standard care alone. Baseline demographic data as well as sleep study data was recorded in all patients. Office blood pressure, heart rate, Epworth sleepiness scale (ESS) score, and quality of life (SF-36) of the two groups were compared after 1-month treatment.

RESULTS: Compared with control group, CPAP treatment markedly reduced the morning diastolic BP (Δ -0.8 ± 6.0 vs. Δ -5.1 ± 6.5, respectively, P = 0.023) and improved ESS scores (Δ -0.5 ± 3.2 vs. Δ -5.2 ± 3.1, P < 0.001). In contrast, there were no significant changes in systolic BP (Δ -0.3 ± 7.3 vs. Δ -3.8 ± 11.8, P = 0.225), heart rate, and quality of life.

CONCLUSIONS: CPAP treatment for 1 month was associated with significant reduction in diastolic BP and improvement in ESS score. For patients with moderate to severe OSA and CHD under optimal medications, CPAP treatment leads to effective reduction in diastolic blood pressure and improvement in daytime sleepiness.

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Effects of continuous positive airway pressure on blood pressure and daytime sleepiness in obstructive sleep apnea patients with coronary heart diseases under optimal medications

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