Key result
One night of CPAP in moderate-to-severe OSA is linked to a ~14% reduction in SDNNI.
Why the study?
Autonomic dysfunction increases cardiovascular disease risk in obstructive sleep apnea, leading researchers to investigate the effect of positive airway pressure therapy on heart rate variability indices.
Does acute positive airway pressure therapy improve heart rate variability in patients with severe and moderate obstructive sleep apnea?
Observational (n=55)
No
Does acute positive airway pressure therapy improve heart rate variability in patients with severe and moderate obstructive sleep apnea?
Absolute Event Rate: 96.5% vs 111.96%
p-value: p=0.036
Acute PAP therapy over a single night improves autonomic system activity as measured by heart rate variability in patients with moderate to severe obstructive sleep apnea.
Acute CPAP may improve HRV in moderate-severe OSA; hypothesis-generating, needs randomized confirmation before practice change.
INTRODUCTION: Obstructive sleep apnea is an important risk factor for cardiovascular disease. Noninvasive positive pressure ventilation is the standard treatment of this disease, and it can reduce mortality in patients. Dysfunction of the autonomic system is one of the reasons for an increased risk of cardiovascular disease in these patients. The purpose of the present study was to investigate the effect of positive airway pressure (PAP) therapy on heart rate variability (HRV) indices. METHODS: The study population was comprised of 55 patients, who underwent nocturnal polysomnography for the diagnosis of obstructive sleep apnea and PAP titration on the same night. The levels of continuous positive airway pressure (CPAP) and bilevel positive airway pressure were adjusted to relieve obstructive sleep apnea, hypopnea, and desaturation. The patients' heart changes and cardiac characteristics were recorded before and after the start of routine CPAP therapy. Finally, the cases' sleep and polysomnography tests were analyzed and interpreted in collaboration with a sleep specialist and their cardiac changes with the aid of a cardiologist before and after treatment with CPAP. RESULTS: =0.008). CONCLUSION: Our findings indicate a relative improvement in the activity of the autonomic system in patients with obstructive sleep apnea after 1 night of PAP therapy. Overwhelming evidence suggests that improvement in the sympathetic balance can reduce the risk of cardiovascular disease in patients.
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Efazati et al. (2020) conducted an observational in Obstructive sleep apnea (n=55). Continuous positive airway pressure (CPAP) vs. Baseline (before treatment) was evaluated on Standard deviation of the N-N interval index (SDNNI) (p=0.036). One night of continuous positive airway pressure therapy in patients with moderate to severe obstructive sleep apnea significantly decreased the standard deviation of the N-N interval index from 111.96 to 96.5.
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