Magnusdottir S, Hilmisson H, Thomas RJ. Cardiopulmonary coupling-derived sleep quality is associated with improvements in blood pressure in patients with obstructive sleep apnea at high-cardiovascular risk. J Hypertens 2020; 38(11):2287-2297. DOI:10.1097/HJH.0000000000002553
Objectives: Investigate if changes in objective sleep quality index (SQI) assessed through cardiopulmonary-coupling analysis impacts blood pressure (BP) in patients with obstructive sleep apnea at high-cardiovascular risk.
Conclusion: In patients with poor sleep quality at baseline (SQI <55), CPAP-therapy improves MAP24 -3.02 (p=0.030) and MAPSleep -5.00 (p=0.001) but in in patients with good baseline-SQI (SQI>55 increased sleep fragmentation (eLFCBB) relative to HLSE-therapy with a difference in margin of 5.48 (p=0.011) and no significant. Significant differences are observed comparing patients that Improved-SQI (SQIBaseline<55,SQIFollow-up≥55) and Declined-SQI (SQIBaseline≥55,SQIFollow-up<55) in MAP24 -4.87 (p=0.046) and MDP24 -4.42 (p=0.026) as well as MAPWake -6.36 (p=0.015), MSPWake -7.80 (p=0.048) and MDPWake-5.64 (p=0.009), respectively.
Practical Significance: Improved SQI reflects the magnitude of positive effect on blood pressure which is reached mostly through initiation of CPAP-therapy in patients with compromised baseline sleep quality. Improved sleep quality positively impacts blood pressure, both during sleep and wake.