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Supplemental oxygen aids hypertension in sleep apnoea patients

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Supplemental oxygen can be used to eliminate the rise in morning blood pressure for patients with obstructive sleep apnoea (OSA), according to a small study, led by UK researchers.

They found supplemental oxygen eliminated the rise in morning blood pressure experienced by OSA patients who stop using continuous positive airway pressure (CPAP) – the standard treatment for OSA.

“This is important because many patients are unable to tolerate using CPAP treatment”

Chris Turnbull

In patients with moderate to severe OSA, supplemental oxygen was found to have prevented a rise in both systolic and diastolic blood pressure.

The study, published in the American Journal of Respiratory and Critical Care Medicine, involved 25 adults living in the UK, all of whom had been using CPAP successfully for over a year.

CPAP was withdrawn for 14 nights, during which time participants first received supplemental oxygen or regular air overnight through a face mask or nasal cannula, and then crossed over to a second CPAP withdrawal period with the opposite treatment.

Neither the researchers nor the participants knew when the participant was receiving the oxygen or the control air therapy.

The study found that supplemental oxygen significantly reduced intermittent hypoxia but had little effect on two markers of arousal – the apnea-hypopnea index, a measure of sleep apnea severity that takes includes episodes of paused and shallow breathing, and the heart rate rises index.

Based on these findings, the study authors said they believed intermittent hypoxia to be the “dominant cause of daytime increase in blood pressure in OSA”.

Study author Dr Chris Turnbull, from the Oxford Centre for Respiratory Medicine at Churchill Hospital, highlighted that the findings might ultimately offer an alternative treatment for some patients.

He said: “This is important because many patients, especially those with few symptoms, are unable to tolerate using CPAP treatment and other treatments may be needed for these individuals.”

“The next challenge for researchers will be to see if supplemental oxygen treatment has similar effects in patients in the longer-term along with assessing its longer-term safety,” he added.

Before supplemental oxygen can be used as an alternative to CPAP, the authors also said more research needs to be conducted to prove its safety.

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