Effect of nCPAP therapy on heart rate in patients with obstructive sleep apnoea-hypopnoea

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Abstract

Background

Elevated heart rate (HR) is a risk factor for cardiovascular disease. The effects of obstructive sleep apnoea-hypopnoea syndrome (OSAHS) on HR are controversial.

Aim

To investigate the effect of nasal continuous positive airway pressure (nCPAP) therapy on HR in OSAHS patients.

Methods

Sixty-two OSAHS patients underwent 24-h electrocardiographic recording, both before and 3 or 4 days after instigation of nCPAP.

Results

After nCPAP was started, HR significantly decreased (mean ± SD 71.8 ± 10.6 vs. 67.5 ± 9.4 bpm, p < 0.0001), both in the daytime (0600–2200 h, 76.3 ± 12.2 vs. 72.2 ± 10.2 bpm, p < 0.0001) and at night-time (2200–0600 h, 64.5 ± 9.1 vs. 60.0 ± 8.9 bpm, p < 0.0001). HR was significantly reduced in both periods in the 44 patients with hypertension and/or diabetes mellitus, but only during the night-time in the 18 with neither condition. Before nCPAP treatment, HR was positively correlated with percentage time of arterial O2 saturation <90% during sleep (p=0.008) and with the apnoea-hypopnoea index during sleep (p=0.003). In 15 patients undergoing HR for 2 days before starting nCPAP, the mean HRs for the two periods were similar (p=0.95).

Discussion

nCPAP therapy appears to decrease HR in OSAHS patients, and may thereby reduce their risk of cardiovascular disease.

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