The impact of continuous positive airway pressure on heart rate variability in obstructive sleep apnea patients during sleep: A meta-analysis

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Heart rate variability (HRV), modulated by cardiac autonomic function, is impaired in obstructive sleep apnea (OSA). However, the effect of continuous positive airway pressure (CPAP) on HRV is debated.


To investigate the associations between CPAP and HRV in OSA.


Based on literature from five databases published through August 2017, we performed a meta-analysis of cohort studies of OSA treated with CPAP. The change of low-frequency band (LF), high-frequency band (HF) and the ratio between LF and HF (LHR) were analyzed.


Eleven studies were included. Decreased LF (SMD = −0.32, 95%CI: −0.62,−0.01; P = 0.043) and HF (SMD = −0.51, 95%CI: −0.95, −0.08, P = 0.020) were shown while measured on CPAP. When measured off CPAP, HF was increased remarkably (SMD: 0.31, 95%CI: 0.02, 0.60, P = 0.034).


CPAP can improve autonomic activity, which might be one mechanism to reduce the risk of cardiovascular diseases in OSA.

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