What question did this study set out to answer?

This report aims to analyze how inappropriate ventilator settings affect hypertension in obstructive sleep apnea patients.

June 1, 2026Open Access

Uncontrolled Hypertension from Inappropriate Ventilator Settings in Obstructive Sleep Apnea: A Case Report

Key Points

This report aims to analyze how inappropriate ventilator settings affect hypertension in obstructive sleep apnea patients.
Case report of a single patient with uncontrolled hypertension and elevated apnea-hypopnea index during bilevel PAP therapy.
Guided retitration of PAP therapy was performed to optimize treatment settings.
Monitoring of blood pressure and apnea-hypopnea index was conducted before and after adjustment.
Following retitration of PAP therapy, blood pressure control improved significantly.
The patient's residual apnea-hypopnea index decreased post-adjustment, indicating better management of sleep apnea.
Overall, the findings stress the importance of appropriate ventilator settings in controlling hypertension.

Abstract

Abstract: This case report explores a typical instance of poorly controlled secondary hypertension associated with obstructive sleep apnea (OSA), specifically exacerbated during bilevel positive airway pressure (PAP) therapy, which was an inappropriate ventilator mode. The patient exhibited uncontrolled blood pressure and a high residual apnea-hypopnea index (AHI) while on bilevel therapy. Following a guided retitration of PAP therapy, both blood pressure control and residual AHI improved substantially. This report aims to provide an in-depth analysis of pathophysiological mechanisms underlying PAP therapy interactions with hypertension in OSA patients and to summarize key points for ventilator management in clinical practice. Keywords: obstructive sleep apnea, bilevel, central sleep apnea, positive airway pressure, hypertension, case report

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