CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases
ObjectiveTo investigate the effects of continuous positive airway pressure (CPAP) therapy on sleep architecture, particularly the microarousal index (MAI), and the frequency of nocturnal acute blood pressure surge events (NBPF) in patients with obstructive sleep apnea (OSA), and to analyze the assoc...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1587127/full |
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| author | Liangcai Yu Lan Shu Simin Gao Lin Li |
| author_facet | Liangcai Yu Lan Shu Simin Gao Lin Li |
| author_sort | Liangcai Yu |
| collection | DOAJ |
| description | ObjectiveTo investigate the effects of continuous positive airway pressure (CPAP) therapy on sleep architecture, particularly the microarousal index (MAI), and the frequency of nocturnal acute blood pressure surge events (NBPF) in patients with obstructive sleep apnea (OSA), and to analyze the association between improvements in sleep architecture (especially reduced MAI) and decreased NBPF.MethodsA retrospective analysis was conducted on 477 patients diagnosed with OSA at the Sleep Medicine Center of West China Fourth Hospital, Sichuan University, between January 2021 and January 2023, who received CPAP therapy (mean age 42.70 ± 10.90 years; mild: 92, moderate: 108, severe: 277). Comparisons were made of polysomnography (PSG)-monitored sleep architecture parameters (N1%, N2%, N3%, R%, MAI) and nocturnal blood pressure indices (SBP, DBP, NBPF) before and after CPAP treatment. NBPF was defined as the number of events per hour where nocturnal systolic blood pressure (SBP) increased by >12 mmHg.Results(1) Baseline characteristics: N1%, N2%, SBP, DBP, and NBPF significantly increased, while R% and N3% significantly decreased with increasing severity of OSA (p < 0.05). (2) Overall efficacy: After CPAP treatment, N1% significantly decreased, N3% significantly increased, and DBP and NBPF significantly decreased (p < 0.05). (3) Subgroup analysis: All patients experienced significant reductions in MAI, N1%, N2%, and NBPF, and significant increases in R% after CPAP treatment (p < 0.05); N3% significantly increased in moderate and severe patients (p < 0.05); SBP and DBP improvements were most significant in severe patients (p < 0.05). (4) Correlation and linear regression analysis: NBPF was significantly correlated with sleep structure parameters, showing an independent positive correlation with MAI (β = 0.375, p < 0.001) and an independent negative correlation with N3% (β = −0.143, p = 0.001).ConclusionThe first night of positive airway pressure (PAP) therapy significantly improves sleep architecture and effectively reduces nocturnal blood pressure while suppressing acute systolic blood pressure (NBPF) elevations in OSA patients, especially those with severe disease. |
| format | Article |
| id | doaj-art-cff74249c73f49a58ed2767b9ec9fe8c |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-cff74249c73f49a58ed2767b9ec9fe8c2025-08-20T03:29:39ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.15871271587127CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe casesLiangcai Yu0Lan Shu1Simin Gao2Lin Li3West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, ChinaZigong Fourth People's Hospital, Zigong, ChinaWest China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, ChinaWest China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, ChinaObjectiveTo investigate the effects of continuous positive airway pressure (CPAP) therapy on sleep architecture, particularly the microarousal index (MAI), and the frequency of nocturnal acute blood pressure surge events (NBPF) in patients with obstructive sleep apnea (OSA), and to analyze the association between improvements in sleep architecture (especially reduced MAI) and decreased NBPF.MethodsA retrospective analysis was conducted on 477 patients diagnosed with OSA at the Sleep Medicine Center of West China Fourth Hospital, Sichuan University, between January 2021 and January 2023, who received CPAP therapy (mean age 42.70 ± 10.90 years; mild: 92, moderate: 108, severe: 277). Comparisons were made of polysomnography (PSG)-monitored sleep architecture parameters (N1%, N2%, N3%, R%, MAI) and nocturnal blood pressure indices (SBP, DBP, NBPF) before and after CPAP treatment. NBPF was defined as the number of events per hour where nocturnal systolic blood pressure (SBP) increased by >12 mmHg.Results(1) Baseline characteristics: N1%, N2%, SBP, DBP, and NBPF significantly increased, while R% and N3% significantly decreased with increasing severity of OSA (p < 0.05). (2) Overall efficacy: After CPAP treatment, N1% significantly decreased, N3% significantly increased, and DBP and NBPF significantly decreased (p < 0.05). (3) Subgroup analysis: All patients experienced significant reductions in MAI, N1%, N2%, and NBPF, and significant increases in R% after CPAP treatment (p < 0.05); N3% significantly increased in moderate and severe patients (p < 0.05); SBP and DBP improvements were most significant in severe patients (p < 0.05). (4) Correlation and linear regression analysis: NBPF was significantly correlated with sleep structure parameters, showing an independent positive correlation with MAI (β = 0.375, p < 0.001) and an independent negative correlation with N3% (β = −0.143, p = 0.001).ConclusionThe first night of positive airway pressure (PAP) therapy significantly improves sleep architecture and effectively reduces nocturnal blood pressure while suppressing acute systolic blood pressure (NBPF) elevations in OSA patients, especially those with severe disease.https://www.frontiersin.org/articles/10.3389/fneur.2025.1587127/fullcontinuous positive airway pressuresleep structureobstructive sleep apneanocturnal blood pressureacute blood pressure surge events |
| spellingShingle | Liangcai Yu Lan Shu Simin Gao Lin Li CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases Frontiers in Neurology continuous positive airway pressure sleep structure obstructive sleep apnea nocturnal blood pressure acute blood pressure surge events |
| title | CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases |
| title_full | CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases |
| title_fullStr | CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases |
| title_full_unstemmed | CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases |
| title_short | CPAP improves sleep stability and attenuates acute nocturnal hypertension (NBPF) in OSA, with maximal benefits in severe cases |
| title_sort | cpap improves sleep stability and attenuates acute nocturnal hypertension nbpf in osa with maximal benefits in severe cases |
| topic | continuous positive airway pressure sleep structure obstructive sleep apnea nocturnal blood pressure acute blood pressure surge events |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1587127/full |
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