Source: Annual Congress 2001 - Cardiovascular pathophysiology in OSA
Disease area: Sleep and breathing disorders

Abstract

In obstructive sleep apnoea syndrome (OSAS), a reduction in respiratory disorders severity is usually observed at CPAP withdrawal after long-term use. As to blood pressure (BP) swings accompanying apnoeas, their variation after long-term CPAP has not been studied. To study this issue, a polysomnography (PSG) under basal conditions (i.e. no CPAP), during which BP was monitored by finapres, was performed before treatment and at CPAP withdrawal after long-term treatment (mean 5 months, range 3-14) in 15 male OSAS patients, aged 47.8 ±] 8.7 (SD) years. Mean daily CPAP use was 5.3 ±] 1.7 hours. After CPAP, AHI decreased from 80.7 ±] 12.6 (SD) to 66.7 ±] 23.5 (p <0.05); mean SaO2 fall in NREM apnoeas (ΔSaO2) decreased from 9.8 ±]3.7% to 6.4 ±] 2.6% (p <0.001). Patients were subdivided into a group of 6 subjects, who showed a decrease in ΔSaO2 >5%, and a group of 9 subjects who showed a decrease in ΔSaO2 <5%. In the first group, mean systolic and diastolic BP rise in NREM apnoeas (ΔPs and ΔPd) decreased respectively from 49.9 ±] 7.3 to 27.4 ±] 5.5 (p <0.005), and from 28.5 ±] 3.5 to 18.2 ±]2.5 mmHg (p <0.002); comparison of apnoeas with similar ΔSaO2 before and after CPAP, showed smaller but still significant differences in ΔPs and ΔPd between the two conditions. In the second group ΔPs varied from 45.8 ±] 9.9 to 38.9 ±] 9.4 (NS), while ΔPd from 27.2 ±]3.5 to 22.7 ±]5.0 mmHg (p<0.05). Variations in ΔPs and ΔPd were not correlated with duration of CPAP use. These data suggest that long-term CPAP may be followed by a decrease in apnoea-associated BP swings; the decrease is partly related to decreased apnoea severity, but could partly be an effect of a reduced sympathetic tone.

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Citations should be made in the following way:
O. Marrone, G. Insalaco, A. Salvaggio, S. Romano, M. R. Bonsignore (Palermo, Italy). Blood pressure reactivity to obstructive apnoeas before and after long-term CPAP. Eur Respir J 2001; 16: Suppl. 31, 3496

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