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Dec 13, 2013

Sleep Apnea Treatment Helps Lower Blood Pressure

Nighttime breathing treatments help lower blood pressure in patients with uncontrolled hypertension and obstructive sleep apnea.

It’s estimated that 18 million Americans suffer from sleep apnea—a common disorder that causes breathing to slow or stop during sleep. Sleep apnea has been linked to increased risk for heart disease and unfortunately, many patients with uncontrolled high blood pressure have this condition, which further increases risk of complications. But according to recent findings, night-time breathing treatments may help lower blood pressure in patients with uncontrolled hypertension.

Obstructive sleep apnea is the most common type of sleep disordered breathing, which affects anywhere from 4-6% of the general middle-aged population. However, it’s much more common among patients with “resistant hypertension”—a condition in which high blood pressure is not effectively managed using typical treatments, like medication and lifestyle changes. In fact, it’s estimated that more than 70% of patients with resistant hypertension have obstructive sleep apnea. The problem is that patients with resistant hypertension are already at increased risk for complications like stroke, and sleep apnea may worsen their prognosis.

That’s why researchers tested a well-known treatment for sleep apnea called continuous positive airway pressure (CPAP) on patients with resistant hypertension. They wondered if addressing breathing problems during sleep might help achieve better blood pressure control, especially at night when interruptions in breathing can raise blood pressure levels.

Results of this study were recently published in the Journal of the American Medical Association and are encouraging for patients with sleep apnea and resistant hypertension. A total of 194 patients with both resistant hypertension and sleep apnea participated in the study and all subjects were assigned to receive CPAP plus their usual blood pressure medication, or blood pressure medication alone. Researchers followed participants for three months, assessing blood pressure at the start and end of the study. After analysis, they found that patients receiving breathing treatment had significantly lower blood pressure levels compared to those without the treatment.

Based on these findings, authors encourage further research to measure long-term impacts of CPAP treatment. If the treatment does, in fact, help lower blood pressure among patients with uncontrolled hypertension, it’s possible that it could help prevent life-threatening complications, like stroke. It’s too early, however, to say whether CPAP has long-term benefits for patients with sleep apnea and resistant hypertension.

Questions for You to Consider

  • How do I know if I have obstructive sleep apnea (OSA)?

  • A telltale sign of OSA is chronic loud snoring, interspersed with sounds of gasping or choking. Often a person isn’t aware of his or her own snoring and it will take a family member or bed partner to point it out. (Not everyone who snores has OSA, however.)  Another prime indicator of OSA for most people is daytime sleepiness, although heart failure patients complain of this symptom less often.

    To confirm that you have OSA, your doctor will send you to an overnight sleep laboratory for specialized testing called polysomnography. If this technology isn’t available where you live, in-home monitoring devices may be an alternative. 

  • What is continuous positive airway pressure (CPAP)?

  • Continuous positive airway pressure (CPAP) is the most common treatment for obstructive sleep apnea.  A CPAP device consists of a face mask that covers your mouth and nose, and a small machine that blows air through the mask into your throat. The air gently presses on the walls of your airways so they do not collapse when your muscles relax during sleep. Most people have a period of adjustment when first using a CPAP machine, but usually feel much better over time.

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