Blood pressure changes after automatic and fixed CPAP in obstructive sleep apnea. Relationship with nocturnal sympathetic activity.

Maria Rosaria Bonsignore, Anna Lo Bue, Maria Rosaria Bonsignore, Giuseppe Insalaco, Loredana Riccobono, Oreste Marrone, Adriana Salvaggio, Anna Bonanno

Risultato della ricerca: Article

23 Citazioni (Scopus)

Abstract

Treatment of obstructive sleep apnea (OSA) by continuous positive airway pressure (CPAP) usually causes a reduction in blood pressure (BP), but several factors may interfere with its effects. In addition, although a high sympathetic activity is considered a major contributor to increased BP in OSA, a relationship between changes in BP and in sympathetic nervous system activity after OSA treatment is uncertain. This study was undertaken to assess if, in OSA subjects under no pharmacologic treatment, treatment by CPAP applied at variable levels by an automatic device (APAP) may be followed by a BP reduction, and if that treatment is associated with parallel changes in BP and catecholamine excretion during the sleep hours. Nine subjects underwent 24-h ambulatory BP monitoring and nocturnal urinary catecholamine determinations before OSA treatment and 2 months following OSA treatment by APAP (Somnosmart2, Weinmann, Hamburg, Germany). Eight control subjects were treated by CPAP at a fixed level. After APAP treatment, systolic blood pressure (SBP) decreased during sleep (p < 0.05), while diastolic blood pressure (DBP) decreased both during wakefulness (p < 0.05) and sleep (p < 0.02). Similar changes were observed in subjects receiving fixed CPAP. Nocturnal DBP changes were correlated with norepinephrine (in the whole sample: r = .61, p < 0.02) and normetanephrine (r = .71, p < 0.01) changes. In OSA subjects under no pharmacologic treatment, APAP reduces BP during wakefulness and sleep, similarly to CPAP. A reduction in nocturnal sympathetic activity could contribute to the reduction in DBP during sleep following OSA treatment.
Lingua originaleEnglish
pagine (da-a)373-380
Numero di pagine8
RivistaClinical and Experimental Hypertension
Volume33
Stato di pubblicazionePublished - 2011

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology

Cita questo

Bonsignore, M. R., Bue, A. L., Bonsignore, M. R., Insalaco, G., Riccobono, L., Marrone, O., Salvaggio, A., & Bonanno, A. (2011). Blood pressure changes after automatic and fixed CPAP in obstructive sleep apnea. Relationship with nocturnal sympathetic activity. Clinical and Experimental Hypertension, 33, 373-380.