Key result
Acute CPAP titration links to reduced HRV frequency band power in moderate to severe OSA.
Why the study?
Autonomic dysregulation is associated with cardiovascular consequences in OSA, prompting investigation into the acute effects of CPAP on autonomic activity and determinants of HRV changes.
Does acute continuous positive airway pressure (CPAP) treatment improve heart rate variability in patients with moderate to severe obstructive sleep apnea?
Observational (n=402)
Does acute continuous positive airway pressure (CPAP) treatment improve heart rate variability in patients with moderate to severe obstructive sleep apnea?
Acute CPAP titration significantly improves heart rate variability parameters in patients with moderate to severe OSA, indicating a restoration of autonomic function.
Acute CPAP may improve autonomic balance in moderate-severe OSA; hypothesis-generating and requires randomized confirmation before practice change.
Autonomic dysregulation is associated with cardiovascular consequences in obstructive sleep apnea (OSA). This study aimed to investigate the effect of acute continuous positive airway pressure (CPAP) treatment on autonomic activity and to identify factors contributing to the heart rate variability (HRV) changes in OSA. Frequency domain HRV parameters were calculated and compared between the baseline polysomnography and during the CPAP titration in 402 patients with moderate to severe OSA. There were significant reductions in total power, very low-frequency band power, low-frequency band power, and high-frequency band power during the CPAP titration as compared to the baseline polysomnography. This tendency was more pronounced in men than in women, and in patients with severe OSA than those with moderate OSA. Multivariate analysis found that changes in apnea-hypopnea index and oxygen saturation were significantly associated with changes in sympathetic and parasympathetic activity, respectively. This study demonstrated that HRV parameters significantly changed during the CPAP titration, indicating a beneficial effect of CPAP in restoration of sympathetic and parasympathetic hyperactivity in OSA. Prospective longitudinal studies should determine whether long-term CPAP treatment aids in maintaining the long-lasting improvement of the autonomic functions, thereby contributing to the prevention of cardiovascular and cerebrovascular diseases in patients with OSA.
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Shin et al. (2023) conducted an observational in Obstructive sleep apnea (n=402). Continuous positive airway pressure (CPAP) vs. Baseline polysomnography was evaluated on Frequency domain heart rate variability parameters. Acute CPAP titration significantly reduced total, very low-, low-, and high-frequency band power in heart rate variability compared to baseline in patients with moderate to severe OSA.
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