Continuous positive airway pressure treatment improves baroreflex control of heart rate during sleep in severe obstructive sleep apnea syndrome

Maria R. Bonsignore, Gianfranco Parati, Giuseppe Insalaco, Oreste Marrone, Paolo Castiglioni, Salvatore Romano, Marco Di Rienzo, Giuseppe Mancia, Giovanni Bonsignore

Research output: Contribution to journalArticlepeer-review

Abstract

The role of the arterial baroreflex in the cardiovascular changes associated with the obstructive sleep apnea syndrome (OSAS), and the effect of nasal continuous positive airway pressure (CPAP) treatment on baroreflex function during sleep are unknown. Baroreflex control of heart rate was studied in 29 normotensive patients with OSAS under no treatment, in 11 age-matched control subjects, and in 10 patients at CPAP withdrawal after 5.5 ± 3.7 (range 3-14) months of treatment. Baroreflex control of heart rate was assessed by "sequence method" analysis of continuous blood pressure recordings (Finapres) obtained during nocturnal polysomnography. In untreated OSAS, baroreflex sensitivity (BRS) was low during wakefulness and non-rapid eye movement (REM) stage 2 sleep compared with control subjects, and correlated inversely with mean lowest SaO2 and the blood pressure increase after apneas. After CPAP treatment, the apnea-hypopnea index was lower, and mean lowest SaO2 higher than before treatment. After CPAP, patients were more bradycardic, blood pressure and its standard deviation decreased as SaO2 improved in non-REM stage 2 sleep, and BRS increased (nocturnal wakefulness: +59%; non-REM stage 2 sleep: +68% over pretreatment values). Our data suggest that baroreflex dysfunction in OSAS may be at least partly accounted for by nocturnal intermittent hypoxemia, and can be reversed by long-term CPAP treatment.

Original languageEnglish
Pages (from-to)279-286
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume166
Issue number3
DOIs
Publication statusPublished - Aug 1 2002

Keywords

  • Autonomic nervous system
  • Hypertension
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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