If you have sleep apnea and your doctor has recommended the use of a CPAP or continuous positive air pressure machine while you sleep, you should be following his recommendation. But if you have sleep apnea and high blood pressure, new research indicates that using your CPAP machine is even more important.
The debate over the link between obstructive sleep apnea (OSA) and high blood pressure has been ongoing for more than 3 decades. After realizing that many patients with OSA also had high blood pressure in the 1980’s, researchers went to work trying to determine if one caused the other. But even after decades of debate and research, the results remain inconclusive. At the heart of the matter is the fact that both conditions share many of the same risk factors like obesity, age, smoking, and lack of exercise. They are simply too interconnected to be able to determine if OSA causes high blood pressure or if high blood pressure somehow contributes to OSA.
Without any conclusive proof one way or the other, the medical community has settled on the idea that OSA is a risk factor for high blood pressure and high blood pressure is a risk factor for OSA. With that settled, one of the goals was to determine how best to treat rises in blood pressure that occur as a result of the apneas caused by OSA during sleep.
OSA causes people to stop breathing while they are sleeping for a period of time that can last from a few seconds to as long as a minute. When this happens, the blood pressure goes up as the lack of oxygen coming in through the lungs signals the brain to take immediate action to ensure continued oxygen to the heart and brain.
The most common way to treat OSA is with a CPAP machine which forces air into the person’s airway while they sleep to prevent the airway from becoming obstructed and the apneas from occurring. Researchers wanted to understand if this common OSA treatment was also effective at lowering blood pressure.
As part of the ‘HeartBEAT Study’, which looks at ways to prevent heart problems in those who have OSA, researchers from Brigham and Women’s Hospital compared the effects of CPAP machines and supplemental oxygen in those with obstructive sleep apnea and high blood pressure. The goal was to determine what effect the use of a CPAP machine had on those OSA patients with high blood pressure. Reducing blood pressure is important in these patients as other research initiatives have shown that lowering blood pressure reduces the risk of dying from a stroke or from a cardiovascular event.
The study included 318 patients who were between the ages of 45 and 75 and who had moderately severe OSA. The participants were randomly assigned to use a CPAP machine at night, to receive lifestyle education, or to receive lifestyle education and use either supplemental oxygen or CPAP machine at night. Each participant’s blood pressure was monitored for 24 hours at the beginning of the study and again after they had been following the protocol assigned to them for 12 weeks.
The results indicate that using a CPAP machine provides the most benefit to those who suffer from both conditions.