title: Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as ≥4 h of use/night for ≥70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence.
  
  
  METHODS
  We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n = 29), (2) low CPAP adherence (n = 28), and (3) high CPAP adherence (n = 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up.
  
  
  RESULTS
  The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the low-adherence group, blood pressure remained unchanged.
  
  
  CONCLUSIONS
  CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for ≥4 h/night for ≥70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Yang
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine.
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Chou-Chin
authors.initials: CC
authors.lastname: Lan
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Yao-Kuang
authors.initials: YK
authors.lastname: Wu
authors.affiliation: Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan. School of Medicine, Tzu Chi University, Hualien, Taiwan. kuofeng1234@gmail.com.
authors.forename: Kuo-Feng
authors.initials: KF
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology; D045422:Continuous Positive Airway Pressure / Q000379:methods / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013995:Time; D016896:Treatment Outcome
keywords: CPAP; blood pressure; obstructive sleep apnea; sleep quality