Was regular CPAP use linked to better sleep and blood pressure?

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Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular diseases. Continuous positive airway pressure (CPAP) is the first treatment choice for moderate-to-severe OSA, but acceptance and adherence remain problematic. High adherence is generally defined as using CPAP for at least 4 hours per night on at least 70% of monitored nights.

Researchers investigated the long-term benefits of CPAP for sleep quality and blood pressure according to adherence. They retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. The subjects were divided into three groups: no CPAP treatment (29), low CPAP adherence (28), and high CPAP adherence (64). All were followed for at least one year. The groups were compared on anthropometric and polysomnographic variables, the presence of cardiovascular comorbidities, and blood pressure at baseline and the last follow-up.

The no-treatment group had significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvements in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. In the low-adherence group, AHI also decreased significantly after CPAP treatment, but blood pressure remained unchanged.

The researchers concluded that benefits to both sleep quality and blood pressure occurred only in the high-adherence group, which used CPAP for at least 4 hours per night on at least 70% of monitored nights. The low-adherence group benefited in AHI, but not blood pressure.