Effects of continuous positive airway pressure versus supplemental oxygen on 24-hour ambulatory blood pressure.
Obstructive sleep apnea (OSA) is associated with recurrent episodes of nocturnal hypoxia and increased risk for development of systemic hypertension. Prior studies have been limited, however, in their ability to show reduction in blood pressure after continuous positive airway pressure (CPAP) therapy, and the effect of supplemental oxygen alone on blood pressure in OSA has not been evaluated. We performed a randomized, double-blind, placebo-controlled study comparing the effects of 2 weeks of CPAP versus sham-CPAP versus supplemental nocturnal oxygen on 24-hour ambulatory blood pressure in 46 patients with moderate-severe OSA. We found that 2 weeks of CPAP therapy resulted in a significant reduction in daytime mean arterial and diastolic blood pressure and nighttime systolic, mean, and diastolic blood pressure (all Ps <0.05). Although nocturnal supplemental oxygen therapy improved oxyhemoglobin saturation, it did not affect blood pressure. We conclude that CPAP therapy reduces both daytime and nighttime blood pressure in patients with OSA, perhaps through mechanisms other than improvement of nocturnal oxyhemoglobin saturation.
Norman
Daniel
D
Department of Medicine, School of Medicine, University of California, San Diego, CA, USA. d1norman@ucsd.edu
Loredo
José S
JS
Nelesen
Richard A
RA
Ancoli-Israel
Sonia
S
Mills
Paul J
PJ
Ziegler
Michael G
MG
Dimsdale
Joel E
JE
D000328:Adult; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D045422:Continuous Positive Airway Pressure; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage / Q000627:therapeutic use*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome
D010100:Oxygen