Effects of Continuous Positive Airway Pressure Titration on Nocturnal Blood Pressure Fluctuation in Severe Sleep Apnea Patients with Hypertension

Abstract

This case report presents two hypertensive patients with severe sleep apnea (SA) who were effectively treated with optimized SA therapy using manual continuous positive airway pressure (CPAP) titration.
Case 1: A 52-year old woman was receiving treatment for severe obstructive SA and hypertension. She noticed residual drowsiness after the initiation of auto-adjusting CPAP. After manual CPAP titration, her sleepiness improved, and home blood pressure (BP) values were almost completely controlled, despite the reduced use of antihypertensives.
Case 2: A 68-year old man with chronic heart failure was receiving treatment for severe SA by means of auto-adjusting CPAP. A favorable decrease in morning BP was observed after manual CPAP titration.
Remarkable antihypertensive effects were observed in hypertensive patients with severe SA after administering individualized and optimized CPAP therapy. SA treatment that is optimized with CPAP titration should be considered as an approach for strict antihypertensive management in hypertensive SA patients.