Effects of continuous positive airway pressure on blood pressure in obstructive sleep apnea patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES)
AffiliationUniv Arizona, Asthma & Airways Dis Res Ctr
MetadataShow full item record
CitationJavaheri, S, Gottlieb, DJ, Quan, SF. Effects of continuous positive airway pressure on blood pressure in obstructive sleep apnea patients: The Apnea Positive Pressure Long‐term Efficacy Study (APPLES). J Sleep Res. 2020; 29:e12943. https://doi.org/10.1111/jsr.12943
JournalJOURNAL OF SLEEP RESEARCH
Rights© 2019 European Sleep Research Society.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractObstructive sleep apnea is associated with hypertension, and short-term studies have demonstrated a modest reduction in blood pressure with continuous positive airway pressure therapy. We evaluated the effects of continuous positive airway pressure versus sham continuous positive airway pressure on blood pressure in 1,101 participants with obstructive sleep apnea from the Apnea Positive Pressure Long-term Efficacy Study, a randomized, sham-controlled double-blinded study designed to assess the impact of continuous positive airway pressure on neurocognition. Participants with apnea-hypopnea index >= 10 were randomly assigned to continuous positive airway pressure or sham continuous positive airway pressure. Blood pressures measured in the morning and evening at baseline, 2 months and 6 months were analysed post hoc using a mixed-model repeated-measures analysis of variance. The largest magnitude reduction was approximately 2.4 mmHg in morning systolic pressure that occurred at 2 months in the continuous positive airway pressure arm as compared with an approximate 0.5 mmHg reduction in the sham group (continuous positive airway pressure effect -1.9 mmHg, p = .008). At 6 months, the difference between groups was diminished and no longer statistically significant (continuous positive airway pressure effect -0.9 mmHg, p = .12). Sensitivity analysis with use of multiple imputation approaches to account for missing data did not change the results. Treatment with continuous positive airway pressure for obstructive sleep apnea reduces morning but not evening blood pressure in a population with well-controlled blood pressure. The effect was greater after 2 than after 6 months of treatment.
Note12 month embargo; published online: 14 November 2019
VersionFinal accepted manuscript
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Associations Between Sleep Quality, Sleep Architecture and Sleep Disordered Breathing and Memory After Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea in the Apnea Positive Pressure Long-term Efficacy Study (APPLES)Quan, Stuart F; Budhiraja, Rohit; Kushida, Clete A; Univ Arizona, Asthma & Airways Res Ctr (BRAZILIAN ASSOC SLEEP, 2018)Sleep architecture, sleep quality and SDB improved in the CPAP group at 6 months; performance on the Buschke and DSST improved equally in both CPAP and Sham CPAP groups. There also were no significant correlations between changes in the amount or percentage of sleep stages between baseline and the 6 months, and corresponding changes in either the Buschke or the DSST. However, when stratified by the upper quartile and lower 3 quartiles, greater changes in the Buschke occurred over 6 months in the top quartile of total sleep time (5.7±7.3 vs. 4.0±6.8, p≤0.01) and amount of N3 sleep (55.9±7.7 vs. 53.6±8.9 min, p≤0.01). Those with more %N3 at 6 months scored better on the Buschke as well (55.9±7.8 vs. 53.6±8.9, p≤0.01). Borderline improvement in the DSST over 6 months was observed in the top quartiles of amount of N3 and %N3. Those in the top quartile of the amount of REM and %REM also showed greater improvement in the Buschke after 6 months. No differences were observed for the AHI, but those in the top quartile of oxygen desaturation had worse scores on the Buschke at 6 months. CPAP/Sham CPAP adherence did not impact 6 month Buschke or DSST performance.
Decision-making under time pressure: The effects of time pressure on information search strategy, decision strategy, consistency, and outcome quality.Nunamaker, Jay; Smith, Charles Adams Plater.; George, Joey F.; Weisband, Suzanne; Darrell, Sabers (The University of Arizona., 1990)The design of information systems to support crisis management can be improved when more is known about the ways in which people process information under time pressure. A laboratory experiment was conducted to investigate the effects of time pressure on decision behavior. The decision task required the subjects to use a computerized information display to search for information under time pressure. When the time limit for searching expired, the subjects were required to make a decision. The decision task type, choice or judgment, and three separate information display formats were also manipulated. A total of 144 student subjects were randomly assigned to the resulting six combinations of task/display treatments. Each subject performed the decision task at three levels of time pressure. Dependent measures included information search strategy, decision strategy, decision consistency, and decision quality. Analyses of the results suggest that time pressure had no effect on the information search strategy or the decision strategy. For five of the six task/display groups, time pressure was inversely related to consistency and quality. One group exhibited an inverted U relationship between time pressure and consistency. Display format had an effect on information search strategy. Task type had an effect on both consistency and quality; the performances of the choice groups were superior to those of the judgment groups. The implications of these findings with respect to the design of information systems is discussed.