Sleep Apnea Treatment May Prevent Hypertension

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Studies Taken Together Suggest Prevention Benefit

"Treatment may not only reduce blood pressure (although modestly on average), but if confirmed by future studies, also may prevent hypertension in at-risk patients. Thus, OSA deserves attention in patients with or at risk of developing hypertension as a potentially treatable cause of hypertension as well as other clinically important outcomes."

However, they said additional clinical trials were needed to determine the amount of CPAP therapy necessary to achieve a beneficial effect, and to evaluate other sleep apnea treatments.

Because so many apnea patients complain that they cannot tolerate wearing a mask throughout the night, Somers said that industry is "trying to develop new ways of delivering positive airway pressure that are more tolerable." He said the idea is for the machines to deliver constant air flow throughout the night, increasing the pressure when it's needed. That way, the treatment "will be primarily instituted" when breathing is blocked, "and when you're breathing quietly and happily, you don't need it."

The sleep apnea pipeline includes new technology being developed to address some of the neurologic issues that underlie disrupted breathing to reduce apnea episodes. One approach now being tested involves stimulating nerves that control how the body keeps the airways open, Somers said.

Rowley said that for now, none of the other treatments used for OSA, including surgery, some oral appliances that reposition the jaw, CPAP masks, or even devices in the pipeline "have been studied for long-term outcomes of OSA, particularly cardiovascular disease. Most of the data is short-term and relates to subjective symptoms such as sleepiness and quality of life."

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