Study Objectives:

We determined the relationship of cardiovascular risk factors (CRF), cardiovascular diseases (CVD), nocturnal blood pressure (NBP) and nocturnal blood pressure fluctuations (NBPFs) with the severity of obstructive sleep apnea (OSA). We also investigated the effect of short-term continuous positive airway pressure (CPAP) therapy on NBP parameters.

Methods:

This retrospective study included 548 patients from our cardiac clinic with suspected OSA. Patients underwent polysomnography and continuous NBP measurement using the pulse transit time (PTT). According to their apnea-hypopnea index (AHI), patients were subclassified: Controls (AHI < 5/h), mild (AHI 5 - < 15/h), moderate (AHI 15 - < 30/h) and severe OSA (AHI ≥ 30/h). 294 patients received CPAP therapy.

Results:

Analysis of covariance (ANCOVA) showed that NBP and the frequency of NBPFs were the highest in severe followed by moderate and mild OSA (all p < 0.001). Multivariable regression analysis revealed a significant association of NBPFs with AHI, BMI, systolic NBP and lowest SpO₂. The severity of OSA is also associated with the frequency of obesity, hypertension, diabetes mellitus, atrial fibrillation, heart failure (all p < 0.001) and coronary artery disease (p = 0.035). Short-term CPAP decreased the frequency of NBPFs in all OSA groups and the systolic NBP in severe and moderate but not in mild OSA.

Conclusions:

The severity of OSA is associated with an increase in NBP and NBPFs. CPAP reduces NBP parameters already after the first night. In addition to BP, the diagnosis and therapy of NBPFs should be considered in patients with OSA.

Clinical Trial Registration:

Registry: German Clinical Trials Register; Title: Nocturnal blood pressure and nocturnal blood pressure fluctuations associated with the severity of obstructive sleep apnea; Identifier: DRKS00024087; URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024087

中文翻译：

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夜间血压和夜间血压波动：短期 CPAP 治疗的效果及其与阻塞性睡眠呼吸暂停严重程度的关系

学习目标：

我们确定了心血管危险因素 (CRF)、心血管疾病 (CVD)、夜间血压 (NBP) 和夜间血压波动 (NBPF) 与阻塞性睡眠呼吸暂停 (OSA) 严重程度的关系。我们还研究了短期持续气道正压通气 (CPAP) 治疗对 NBP 参数的影响。

方法：

这项回顾性研究包括来自我们心脏诊所的 548 名疑似 OSA 患者。患者接受了多导睡眠图和使用脉冲传输时间 (PTT) 的连续 NBP 测量。根据他们的呼吸暂停低通气指数 (AHI)，患者被细分为：对照组 (AHI < 5/h)、轻度 (AHI 5 - < 15/h)、中度 (AHI 15 - < 30/h) 和重度 OSA (AHI ≥ 30/小时）。294 名患者接受了 CPAP 治疗。

结果：

协方差分析 (ANCOVA) 表明，NBP 和 NBPFs 的频率在重度 OSA 中最高，其次是中度和轻度 OSA（均 p < 0.001）。多变量回归分析显示 NBPFs 与 AHI、BMI、收缩期 NBP 和最低 SpO ₂显着相关。OSA 的严重程度还与肥胖、高血压、糖尿病、心房颤动、心力衰竭（均 p < 0.001）和冠状动脉疾病（p = 0.035）的频率相关。短期 CPAP 降低了所有 OSA 组的 NBPF 频率和重度和中度的收缩期 NBP，但在轻度 OSA 中没有。

结论：

OSA 的严重程度与 NBP 和 NBPFs 的增加有关。CPAP 在第一晚之后就已经降低了 NBP 参数。OSA 患者除 BP 外，还应考虑 NBPFs 的诊断和治疗。

临床试验注册：

登记处：德国临床试验登记处；标题：与阻塞性睡眠呼吸暂停严重程度相关的夜间血压和夜间血压波动；标识符：DRKS00024087；网址：https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024087