Sleep Disorders

Impact of Upper Airway Stimulation Therapy on 24-Hour Ambulatory Blood Pressure Monitoring

Upper airway stimulation (UAS) is recommended treatment for moderate-to-severe obstructive sleep apnea (OSA) in select patients. The effect of UAS was examined on 24-hour ambulatory blood pressure monitoring (ABPM) measures postimplantation by examining blood pressure (BP) at baseline and at 2, 6, and 12 months follow-up.

Baseline2 Months6 Months12 Months
SBPMean110.5108.1111.5106.6
Lower limit94.391.193.591.6
Upper limit126.7125.1129.5121.6
DBPMean66.265.66765.2
Lower Limit58.855.556.156.3
Upper Limit73.675.777.974.1
MAPMean81.680.682.880
Lower Limit71.969.170.470.5
Upper Limit91.392.195.289.5

At 12 months, there were nonsignificant overall mean reductions in systolic [-0.55 mm Hg , P = 0.75], diastolic [-0.73 mm Hg, P = 0.63], and mean arterial pressure (MAP) [-0.55 mm Hg, P = 0.71]. Mean sleeping systolic, diastolic, and MAP changed by -4.36 (P = 0.34), -1.45 (P = 0.57), -2.18 (P = 0.50), respectively. Positive correlations above 0.25 (P < 0.10) were observed between all dipping percentage measures and total sleep time. Negative correlations were seen between overall systolic, diastolic, and MAP with sleep latency (-0.22, P = 0.19, -0.35, P = 0.031, and -0.29, P = 0.075, respectively). Although consistent reduction of BP measures was observed post-UAS implantation, findings were not statistically significant. It is unclear whether this is due to insufficient sample size or true lack of effect. These results suggest favorable BP profiles after UAS in OSA which may be driven by sleep duration and latency.