Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep MedicineJul 27, 2021

Nighttime blood pressure and its changes linked to sleep apnea severity and short-term CPAP treatment

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 6, 2026

Abstract

In a study of 548 patients, the severity of obstructive sleep apnea (OSA) is associated with increased nocturnal blood pressure (NBP) and fluctuations in NBP.

The highest levels of NBP and frequency of NBP fluctuations were observed in patients with severe OSA, followed by moderate and mild OSA.
Significant associations were found between NBP fluctuations and factors such as the apnea-hypopnea index, body mass index, systolic NBP, and lowest oxygen saturation.
The severity of OSA is linked to a higher prevalence of obesity, hypertension, diabetes, atrial fibrillation, heart failure, and coronary artery disease.
Short-term continuous positive airway pressure therapy reduced NBP fluctuations across all OSA severity groups and lowered systolic NBP in severe and moderate cases, but not in mild OSA.

Simplified

STUDY OBJECTIVES: We determined the relationship of cardiovascular risk factors, cardiovascular diseases, nocturnal blood pressure (NBP), and NBP fluctuations (NBPFs) with the severity of obstructive sleep apnea (OSA). We also investigated the effect of short-term continuous positive airway pressure therapy on NBP parameters.

METHODS: This retrospective study included 548 patients from our cardiac clinic with suspected OSA. Patients underwent polysomnography and continuous NBP measurement using the pulse transit time. According to their apnea-hypopnea index (AHI), patients were subclassified as controls (AHI < 5 events/h), mild (AHI 5 to < 15 events/h), moderate (AHI 15 to < 30 events/h), and severe OSA (AHI ≥ 30 events/h); 294 patients received continuous positive airway pressure therapy.

RESULTS: Analysis of covariance showed that NBP and the frequency of NBPFs were the highest in severe followed by moderate and mild OSA (all< .001). Multivariable regression analysis revealed a significant association of NBPFs with AHI, body mass index, systolic NBP, and lowest SpO. The severity of OSA is also associated with the frequency of obesity, hypertension, diabetes mellitus, atrial fibrillation, heart failure (all< .001), and coronary artery disease (= .035). Short-term continuous positive airway pressure decreased the frequency of NBPFs in all OSA groups and the systolic NBP in severe and moderate but not in mild OSA. P P P2

CONCLUSIONS: The severity of OSA is associated with an increase in NBP and NBPFs. Continuous positive airway pressure reduces NBP parameters already after the first night. In addition to BP, the diagnosis and therapy of NBPFs should be considered in patients with OSA.

CLINICAL TRIAL REGISTRATION: Registry: German Clinical Trials Register; Name: Nocturnal blood pressure and nocturnal blood pressure fluctuations associated with the severity of obstructive sleep apnea; URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024087; Identifier: DRKS00024087.

CITATION: Picard F, Panagiotidou P, Tammen A-B, et al. 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.2022;18(2):361-371. J Clin Sleep Med.

Funding

Competing interests

All authors have seen and approved the manuscript. Work for this study was performed at the Department of Cardiology, Augusta Hospital Düsseldorf, Academic Teaching Hospital of the University Faculty of Health, Düsseldorf, Germany. The authors report no conflicts of interest.

PubMed

Nighttime blood pressure and its changes linked to sleep apnea severity and short-term CPAP treatment

Abstract

Funding

Competing interests

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Abstract

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