The effect of CPAP therapy on blood pressure in the mild obstructive sleep apnea population

Michelle L. Nelson

Journal of Nursing Education and Practice ›› 2025, Vol. 15 ›› Issue (2) : 21 -29.

PDF (483KB)
Journal of Nursing Education and Practice ›› 2025, Vol. 15 ›› Issue (2) :21 -29. DOI: 10.5430/jnep.v15n2p21
Original Research
research-article

The effect of CPAP therapy on blood pressure in the mild obstructive sleep apnea population

Author information +
History +
PDF (483KB)

Abstract

This retrospective study uniquely focused on the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with mild obstructive sleep apnea (OSA), a condition characterized by intermittent upper airway collapse. OSA is a well-established risk factor for hypertension, with positive airway pressure (PAP) therapy being the most common treatment. While substantial evidence supports PAP therapy in moderate and severe OSA, the impact of CPAP on mild OSA, which accounts for 50%-70% of all cases, remains underexplored. The primary objective of this study was to investigate whether CPAP therapy, particularly the degree of adherence to treatment, has a measurable impact on blood pressure regulation in patients with mild OSA. Specifically, this research aimed to evaluate whether consistent CPAP use could lower systolic and diastolic blood pressure and assess how varying levels of adherence influence these outcomes. Participants were stratified into two groups based on CPAP adherence: Group A (n = 45) included those who used CPAP for four or more hours per night on at least 70% of nights, while Group B (n = 15) consisted of those with less than four hours of CPAP use per night on 70% of nights. Interestingly, greater systolic and diastolic blood pressure reductions were observed in Group B, suggesting that lower CPAP adherence may still contribute to significant cardiovascular improvements. These findings offer new insights into the management of blood pressure in patients with mild OSA and the role of CPAP adherence.

Keywords

Mild obstructive sleep apnea / Blood pressure / Continuous positive airway pressure

Cite this article

Download citation ▾
Michelle L. Nelson. The effect of CPAP therapy on blood pressure in the mild obstructive sleep apnea population. Journal of Nursing Education and Practice, 2025, 15(2): 21-29 DOI:10.5430/jnep.v15n2p21

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Hendy RM, Hani BM, Mohammed SH. Hematological parameters as predictors of OSA severity. The Egyptian Journal of Bronchology. 2024; 18(3). https://doi.org/10.1186/s43168-024-00318 -6

[2]

Wijata A, Wydeheft L, Janiak M, et al. The effect of obstructive sleep apnea on the cardiovascular system. Journal of Education, Health and Sport. 2022; 12(6): 39-50. https://doi.org/10.12775/JEHS.2022.12.06.003

[3]

Lee JJ, Sundar KM. Evaluation and management of adults with obstructive sleep apnea syndrome. Lung. 2021; 199: 87-101. https://doi.org/10.1007/s00408-021-00426-w

[4]

Visseren FL, Mach F, Smulders YM, et al. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice developed by the task force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC). European Heart Journal. 2021; 42(34): 3227-3337. https://doi.org/10.1093/eurheartj/ehab484

[5]

Xia W, Jing Y, Yuan C. Correlation between Obstructive Sleep Apnea Syndrome (OSAS) and cognitive dysfunction in elderly patients with hypertension. Journal of Integrative Neuroscience. 2023; 22(4). https://doi.org/10.31083/j.jin2204083

[6]

Williams LB, Mancia EG, Spiering YHW, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. Journal of Hypertension. 2018; 36(10): 1953-2041. https://doi.org/10.1097/HJH.00000000000019

[7]

Bouloukaki I, Grote L, McNicholas WT, et al. Mild obstructive sleep apnea increases hypertension risk, challenging traditional severity classification. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine. 2020; 16(6): 889-898. https://doi.org/10.5664/jcsm.8354

[8]

Vgontzas AN, Li Y, He F, et al. Mild-to-moderate sleep apnea is associated with incident hypertension: age effect. Sleep. 2019; 42(4). https://doi.org/10.1093/sleep/zsy265

[9]

Gottlieb DJ, Punjabi NM, Diagnosis and management of obstructive sleep apnea. JAMA. 2020; 323(14): 1389-1400. https://doi.org/10.1001/jama.2020.3514

[10]

Davidson TM. The great leap forward: The anatomic basis for the acquisition of and obstructive sleep apnea. Sleep Medicine. 2003; 4(3): 185-194. https://doi.org/10.1016/S1389-9457(02)00237-X

[11]

Mediano O, Romero-Peralta S, Resano P, et al. Obstructive sleep apnea: Emerging treatments targeting the genioglossus muscle. Journal of Clinical Medicine. 2019; 8: 1754. https://doi.org/10.3390/jcm8101754

[12]

Cori JM, O-Donoghue F, Jordan AS. Sleeping tongue: current perspectives of genioglossus control in healthy individuals and patients with obstructive sleep apnea. Nature and Science of Sleep. 2018; 10: 169-179. https://doi.org/10.2147/NSS.S143296

[13]

El-Solh AA, Lawson Y, Wilding GE. Impact of low arousal threshold on treatment of obstructive sleep apnea in patients with posttraumatic stress disorder. Sleep and Breathing. 2021; 25(2): 597-604. https://doi.org/10.1007/s11325-020-02106-0

[14]

Kim LJ, Freire C, Fleury Curado T, et al. The role of animal models in developing pharmacotherapy for obstructive sleep apnea. Journal of Clinical Medicine. 2019. https://doi.org/10.3390/jcm8122049

[15]

Eckert DJ. Phenotypic approaches to obstructive sleep apnoea - New pathways for targeted therapy. Sleep Medicine Reviews. 2018; 37: 45-59. https://doi.org/10.1016/j.smrv.2016.12.003

[16]

Gunta SP, Jakulla RS, Ubaid A, et al. Obstructive sleep apnea and cardiovascular diseases: Sad realities and untold truths regarding care of patients in 2022. Cardiovascular Therapeutics. 2022.

[17]

Chang HP, Chen YF, Du JK. Obstructive sleep apnea treatment in adults. Kaohsiung Journal of Medical Sciences. 2020; 36: 7-12.

[18]

Won CH, Qin L, Selim B, et al. Varying hypopnea definitions affect obstructive sleep apnea severity classification and association with cardiovascular disease. Journal of Clinical Sleep Medicine. 2018; 14(12). https://doi.org/10.5664/jcsm.7520

[19]

American Academy of Sleep Medicine. The International Classification of Sleep Disorders. 3rd ed. Darien, IL: Author. 2014.

[20]

Metin M, Avcu M. Is the examination of a single night polysomnography sufficient for a diagnosis of OSAS in adolescent patients? Erciyes Medical Journal. 2021; 43(4): 361-365.

[21]

Han B, Chen WZ, Li YC, et al. Sleep and hypertension. Sleep and Breathing. 2020; 24(1): 351-356. https://doi.org/10.1007/s11325-019-01907-2

[22]

Yuan FJ, Zhang SS, Liu X, et al. Correlation between obstructive sleep apnea hypopnea syndrome and hypertension: A systematic review and meta-analysis. Annals of Palliative Medicine. 2021; 10(12): 12251-12261. https://doi.org/10.21037/apm-21-3302

[23]

Mokros L, Kuczynski W, Franczak L, et al. Morning diastolic blood pressure may be independently associated with severity of obstructive sleep apnea in non-hypertensive patients: A cross-sectional study. Journal of Clinical Sleep Medicine. 2017; 13(7): 905-910. https://doi.org/10.5664/jcsm.6664

[24]

Brown J, Yazdi F, Jodari-Karimi M, et al. Obstructive sleep apnea and hypertension: Updates to a critical relationship. Current Hypertension Reports. 2022; 24: 173-184. https://doi.org/10.1007/s11906-022-01181-w

[25]

Pallangyo P, Mgopa LR, Mkojera Z, et al. Obstructive sleep apnea and associated factors among hypertensive patients attending a tertiary cardiac center in Tanzania: A comparative cross-sectional study. Sleep Science Practice. 2021; 5(17). https://doi.org/10.1186/s41606-021-00069-z

[26]

Peppard PE, Young T, Palta M, et al. Prospective study of the association between sleep-disordered breathing and hypertension. New England Journal of Medicine. 2000; 342(19): 1378-1384. https://doi.org/10.1056/NEJM200005113421901

[27]

Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2019; 15(2): 335-343. https://doi.org/10.5664/jcsm.7640

[28]

Baratta F, Pastori D, Fabiani M, et al. Severity of OSAS, CPAP and cardiovascular events: A follow-up study. European Journal of Clinical Investigation. 2018; 48: e12908. https://doi.org/10.1111/eci.12908

[29]

Martinez-Garcia MA, Oscullo G, Ponce S, et al. Effect of continuous positive airway pressure in very elderly with moderate-tosevere obstructive sleep apnea pooled results from two multicenter randomized controlled trials. Sleep Medicine. 2022; 89: 71-77. https://doi.org/10.1016/j.sleep.2021.11.009

[30]

Chowdhuri S, Quan SF, Almeida F, et al. An official American Thoracic Society research statement: Impact of mild obstructive sleep apnea in adults. American Journal of Respiratory and Critical Care Medicine. 2016; 193(9): e37-54. https://doi.org/10.1164/rccm.201602-0361ST

[31]

Ersoy E, Mercan Y. Risk factors for obstructive sleep apnea and the association of obstructive sleep apnea with daytime sleepiness, obesity and comorbidity. Journal of Turkish Sleep Medicine. 2021; 1: 20-27. https://doi.org/10.4274/jtsm.galenos.2020.02886

[32]

Ullah M, Tamanna S. Racial disparity in cardiovascular morbidity and mortality associated with obstructive sleep apnea: The sleep heart health study. Sleep Medicine. 2023; 101: 528-534. https://doi.org/10.1016/j.sleep.2022.12.007

[33]

Chaplin H, Ward K. How many hours per night is enough? A systematic review to identify optimal hours of CPAP therapy for sleep apnoea. Health Sciences Review. 2022; 5: 100061. https://doi.org/10.1016/j.hsr.2022.100061

[34]

Cistulli PA, Armitstead J, Pepin JL, et al. Short-term CPAP adherence in obstructive sleep apnea: a big data analysis using real world data. Sleep Medicine. 2020; 59: 114-116. https://doi.org/10.1016/j.sleep.2019.01.004

[35]

Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: The challenge to effective treatment. Proceedings of the American Thoracic Society. 2008; 5(2): 173-178. https://doi.org/10.1513/pats.200708-119MG

PDF (483KB)

120

Accesses

0

Citation

Detail

Sections
Recommended

/