How effective is the treatment of Obstructive Sleep Apnea?
Patients with Obstructive Sleep Apnea experience oxygen desaturation and sympathetic activation. Persistent, untreated Obstructive Sleep Apnea leads to hypertension. In the Wisconsin Sleep Cohort Study, 709 patients were followed for 4 years, and those patients with an apnea-hypopnea index of ≥5 had a more than twofold higher risk for hypertension, compared to patients with no apnea-hypopnea events.
A meta-analysis of five randomized, controlled trials revealed that continuous positive airway pressure (CPAP) therapy improved the blood pressure control of OSA patients: 24-hour systolic and diastolic ambulatory blood pressures decreased 4.78 and 2.95 mm Hg, respectively, compared to no treatment.
While nocturnal ambulatory systolic blood pressure did not change significantly with CPAP, nocturnal ambulatory diastolic blood pressure fell 1.53 mm Hg.
Obstructive Sleep Apnea is common in chronic kidney disease—up to 60% of these patients may have Obstructive Sleep Apnea—and chronic kidney disease may increase sleep apnea severity.
Severe Obstructive Sleep Apnea (apnea-hypopnea index ≥ 30), in conjunction with resistant hypertension, increases the odds of chronic kidney disease by more than 13-fold. It is possible that treatment of Obstructive Sleep Apnea in chronic kidney disease patients may improve blood pressure control and kidney outcomes.