Effect Of CPAP Treatment Research Articles

S14 CPAP improves endothelial function in minimally symptomatic OSA patients: results from the MOSAIC trial

BackgroundCPAP treatment for symptomatic OSA improves surrogate markers of cardiovascular risk, such as endothelial function and arterial stiffness, and may reduce actual cardiovascular events. Minimally symptomatic OSA is far more...

Obstructive sleep apnoea syndrome promotes reversal albuminuria during sleep

Sleep apnoea syndrome (OSAS) may induce albuminuria during sleep which could reflect one of the possible pathogenetic mechanisms regarding cardiovascular risk. We studied 224 patients with newly diagnosed OSAS, free of any chronic disease, and any regular drug therapy. The levels of urine albumin/creatinine ratio (ACR) before (ACR-bsleep) and immediately after (ACR-asleep) a sleep study were determined. The same procedure was repeated during the first night on CPAP treatment (n = 121) and in 46 reevaluated patients, after 3 months, on CPAP therapy. Ambulatory blood pressure was monitored in 133 of the patients. ACR-asleep was significantly higher in patients (17.82 ± 31.10 mg/g) compared with controls (6.54 ± 6.53 mg/g, p < 0.001). The mean percent change in ACR levels between after and before sleep (%dACR) was increased by 8.82% ± 61.06 in OSAS patients and reduced by 26.87% ± 18.95 in controls (p < 0.001). During the first sleep study on CPAP, the %dACR was reduced by 21.40% ± 24.59, in contrast to the increase observed during the initial study (10.73% ± 69.93, p < 0.001). This beneficial effect of CPAP treatment was preserved in the reevaluated patients. The %dACR was +29.33% ± 57.67 in nondippers (44% of the patients) and -5.57% ± 40.81 in dippers (p < 0.001). It was negatively correlated to the percent change of systolic (rho = -0.284, p = 0.003) and diastolic (rho = -0.341, p < 0.001) blood pressure between wakefulness and sleep. Contrary to normal people, ACR is increased in OSAS patients during sleep, at least partially, related to the nondipping phenomenon observed in these patients. Following CPAP treatment, urinary albumin excretion is reduced.

Obstruktive Schlaf-Apnoe und metabolisches Syndrom

Metabolic syndrome, i. e., the combined occurrence of obesity, arterial hypertension, insulin resistance and dyslipidaemia (increased triglycerides, reduced HDL cholesterol), is associated with a marked increase in cardiovascular risk. The prevalence of metabolic syndrome in patients with obstructive sleep apnoea (OSA) is very high. Obesity is the main risk factor for OSA and OSA itself is now considered to be the most frequent cause of secondary arterial hypertension. Due to the confounding influence of obesity, the causal connection between OSA and metabolic disturbances is less well established, however, epidemiological data are at least in favour of an independent link between OSA and insulin resistance. It is known that CPAP therapy can ameliorate OSA-associated hypertension. In contrast, the effects of CPAP treatment on insulin resistance and dyslipidaemia have to be further elucidated by large, randomised interventional trials.

Obstructive sleep apnoea: What is the evidence for vascular pathogenesis?

Obstructive sleep apnoea: What is the evidence for vascular pathogenesis?

Influence of Treatment with Continuous Positive Airway Pressure on Respiratory Muscle Function and Physical Fitness in Patients with Obstructive Sleep Apnoea and Overlap Syndrome

The aim of this study was to evaluate the effect of CPAP treatment on respiratory muscle strength and exercise tolerance in patients with obstructive sleep apnoea (OSA) and overlap syndrome (OS). 9 patients with OSA and 9 patients with OS were studied. Respiratory muscle assessment, 6 minute walking distance (6MWD) and cycloergometry exercise test were performed before and after six month period of CPAP treatment. In OSA group exercise tolerance did not change after the treatment. Mean 6MWD was 571.8 +/- 76.6 m before and 554.0 +/- 125.5 m after treatment, mean W(max) was 142 +/- 41 W before and 139 +/- 38 W after treatment. PI(max) in OSA group did not change significantly, 140.4 +/- 32.0 cm H(2)O before and 155.9 +/- 31.5 after treatment (p = 0.14). PE(max) improved from 170.5 +/- 49.2 cm H(2)O, to 199.9 +/- 27.6 cm H(2)O (p = 0.067). Handgrip force in OSA group improved from 50.5 +/- 16.5 kg to 61.0 +/- 17.0 kg (left hand) (p = 0.05) and from 53.3 +/- 14.2 to 58.9 +/- 15.9 (right hand) (p < 0.05). In OS group exercise tolerance improved by 17% after CPAP treatment from W(max) = 81 +/- 33 W before to 95 +/- 38 W after. Mean 6MWD was at the same level before (504 +/- 144 m) and after treatment (492 +/- 108 m). PI(max) in OS group improved from 89.2 +/- 35.7 cm H(2)O to 106.3 +/- 31.4 cm H(2)O (p < 0.05). PE(max) in OS group did not change significantly, 159.9 +/- 45.8 cm H(2)O before and 184.2 +/- 45.0 cm H(2)O after treatment (NS). Handgrip force in OS group improved from 38.1 +/- 15.9 kg to 46.9 +/- 11.1 kg (left hand) (p < 0.05) and did not change in right hand (44.5 +/- 17.7 kg vs. 47.9 +/- 10.4 kg) (NS). Data analysis of the whole group (18 pts) showed clear tendency to improve strength of respiratory muscles in patients treated with CPAP. Mean PI(max) improved from 123 to 133 cm H(2)O (p = 0.006) and PE(max) improved from 168.1 to 192 cm H(2)O (p = 0.02). CPAP treatment improved strentgh of respiratory and skeletal muscles in patients with OSA and OS and improved exercise tolerance in patients with OS.

O0015 Effect of CPAP treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome

O0015 Effect of CPAP treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome