New research suggests that treatment with a device known as a CPAP machine can benefit patients with health problems caused by sleeping difficulties.
More than 70% of patients with resistant hypertension – a kind of high blood pressure – have obstructive sleep apnoea, caused by breathing difficulties during sleep.
Although blood pressure is one of the most treatable heart risk factors, and obstructive sleep apnoea may contribute to poor control of blood pressure, evidence is lacking on the benefits of continuous positive airway pressure (CPAP).
This treatment involves a machine that uses continuous mild air pressure to keep the patient’s airway open. It is considered the most effective treatment for obstructive sleep apnoea. So Dr Miguel-Angel Martinez-Garcia of the Hospital Universitario y Politecnico La Fe, Spain, and colleagues set out to examine its effects.
They recruited 194 patients with hard to treat blood pressure and obstructive sleep apnoea at 24 teaching hospitals in Spain. Patients either had CPAP treatment or just their usual blood pressure medication. The average sleep apnoea score was 40, and an average of 3.8 antihypertensive drugs were taken per patient.
After 12 weeks, CPAP treatment was associated with a greater drop in blood pressure, and the percentage of patients with a healthy night-time blood pressure was greater in the CPAP group than among those who did not receive the treatment.
Results are published in the Journal of the American Medical Association today (11 December). The authors write: "Among patients with obstructive sleep apnoea and resistant hypertension, CPAP treatment for 12 weeks compared with control resulted in a decrease in 24-hour mean and diastolic blood pressure and an improvement in the nocturnal blood pressure pattern."
But they add that: "Further research is warranted to assess longer-term health outcomes."
Martínez-García, M. A. et al. Effect of CPAP on Blood Pressure in Patients With Obstructive Sleep Apnoea and Resistant Hypertension: The HIPARCO Randomized Clinical Trial. JAMA 11 December 2013 doi:10.1001/jama.2013.281250
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