Fixed and autoadjusting continuous positive airway pressure treatments are not similar in reducing cardiovascular risk factors in patients with obstructive sleep apnea

Vincenzo Patruno, Stefano Aiolfi, Giorgio Costantino, Rodolfo Murgia, Carlo Selmi, Alberto Malliani, Nicola Montano

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Background: A strong association between obstructive sleep apnea (OSA) and the risk for cardiovascular and cerebrovascular diseases has been reported. Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, able not only to reduce daytime sleepiness but also to improve cardiovascular and metabolic outcomes. Autoadjusting CPAP (APAP), an alternative treatment to CPAP, can reduce OSA symptoms while increasing long-term CPAP compliance without the high costs of CPAP titration. However, no data are available on the effects of APAP on cardiovascular risk factors Methods: We performed standard full polysomnography; obtained plasma levels of glucose, insulin, and C-reactive protein (CRP); and measured systolic BP (SBP) and diastolic BP (DBP) in 31 patients with newly diagnosed, severe OSA. After standard CPAP titration, all subjects were randomized to CPAP or APAP treatment. Measurements were obtained at baseline and after 3 months of treatment. Results: The two groups were similar in terms of age, sex, body mass index (BMI), and severity of OSA. SBP, DBP, heart rate (HM), homeostasis model assessment index (HOMA-IR), and CRP were similar in the two groups. After 3 months of treatment, BMI, HB, and compliance to therapy were also comparable. OSA indexes were significantly reduced in both groups. Significant reductions in SBP, DBF, and HOMA-IM were observed in the CPAP group but not in the APAP group, while CRP plasma levels were similarly reduced. Conclusions: Our results suggest that CPAP and APAP, despite significant effects on OSA indexes and symptoms, do not improve cardiovascular risk factors in the same fashion.

Original languageEnglish (US)
Pages (from-to)1393-1399
Number of pages7
JournalChest
Volume131
Issue number5
DOIs
StatePublished - May 2007
Externally publishedYes

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Continuous Positive Airway Pressure
Obstructive Sleep Apnea
C-Reactive Protein
Therapeutics
Body Mass Index
Cerebrovascular Disorders
Polysomnography
Homeostasis
Cardiovascular Diseases
Heart Rate
Insulin
Costs and Cost Analysis
Glucose

Keywords

  • BP
  • Continuous positive airway pressure
  • Inflammation
  • Insulin resistance
  • Obstructive sleep apnea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Fixed and autoadjusting continuous positive airway pressure treatments are not similar in reducing cardiovascular risk factors in patients with obstructive sleep apnea. / Patruno, Vincenzo; Aiolfi, Stefano; Costantino, Giorgio; Murgia, Rodolfo; Selmi, Carlo; Malliani, Alberto; Montano, Nicola.

In: Chest, Vol. 131, No. 5, 05.2007, p. 1393-1399.

Research output: Contribution to journalArticle

Patruno, Vincenzo ; Aiolfi, Stefano ; Costantino, Giorgio ; Murgia, Rodolfo ; Selmi, Carlo ; Malliani, Alberto ; Montano, Nicola. / Fixed and autoadjusting continuous positive airway pressure treatments are not similar in reducing cardiovascular risk factors in patients with obstructive sleep apnea. In: Chest. 2007 ; Vol. 131, No. 5. pp. 1393-1399.
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AU - Patruno, Vincenzo

AU - Aiolfi, Stefano

AU - Costantino, Giorgio

AU - Murgia, Rodolfo

AU - Selmi, Carlo

AU - Malliani, Alberto

AU - Montano, Nicola

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N2 - Background: A strong association between obstructive sleep apnea (OSA) and the risk for cardiovascular and cerebrovascular diseases has been reported. Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, able not only to reduce daytime sleepiness but also to improve cardiovascular and metabolic outcomes. Autoadjusting CPAP (APAP), an alternative treatment to CPAP, can reduce OSA symptoms while increasing long-term CPAP compliance without the high costs of CPAP titration. However, no data are available on the effects of APAP on cardiovascular risk factors Methods: We performed standard full polysomnography; obtained plasma levels of glucose, insulin, and C-reactive protein (CRP); and measured systolic BP (SBP) and diastolic BP (DBP) in 31 patients with newly diagnosed, severe OSA. After standard CPAP titration, all subjects were randomized to CPAP or APAP treatment. Measurements were obtained at baseline and after 3 months of treatment. Results: The two groups were similar in terms of age, sex, body mass index (BMI), and severity of OSA. SBP, DBP, heart rate (HM), homeostasis model assessment index (HOMA-IR), and CRP were similar in the two groups. After 3 months of treatment, BMI, HB, and compliance to therapy were also comparable. OSA indexes were significantly reduced in both groups. Significant reductions in SBP, DBF, and HOMA-IM were observed in the CPAP group but not in the APAP group, while CRP plasma levels were similarly reduced. Conclusions: Our results suggest that CPAP and APAP, despite significant effects on OSA indexes and symptoms, do not improve cardiovascular risk factors in the same fashion.

AB - Background: A strong association between obstructive sleep apnea (OSA) and the risk for cardiovascular and cerebrovascular diseases has been reported. Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, able not only to reduce daytime sleepiness but also to improve cardiovascular and metabolic outcomes. Autoadjusting CPAP (APAP), an alternative treatment to CPAP, can reduce OSA symptoms while increasing long-term CPAP compliance without the high costs of CPAP titration. However, no data are available on the effects of APAP on cardiovascular risk factors Methods: We performed standard full polysomnography; obtained plasma levels of glucose, insulin, and C-reactive protein (CRP); and measured systolic BP (SBP) and diastolic BP (DBP) in 31 patients with newly diagnosed, severe OSA. After standard CPAP titration, all subjects were randomized to CPAP or APAP treatment. Measurements were obtained at baseline and after 3 months of treatment. Results: The two groups were similar in terms of age, sex, body mass index (BMI), and severity of OSA. SBP, DBP, heart rate (HM), homeostasis model assessment index (HOMA-IR), and CRP were similar in the two groups. After 3 months of treatment, BMI, HB, and compliance to therapy were also comparable. OSA indexes were significantly reduced in both groups. Significant reductions in SBP, DBF, and HOMA-IM were observed in the CPAP group but not in the APAP group, while CRP plasma levels were similarly reduced. Conclusions: Our results suggest that CPAP and APAP, despite significant effects on OSA indexes and symptoms, do not improve cardiovascular risk factors in the same fashion.

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