Continuous positive airway pressure treatment for obstructive sleep apnoea reduces resting heart rate but does not affect dysrhythmias: a randomised controlled trial

Summary Obstructive sleep apnoea (OSA) is associated with cardiovascular morbidity and may precipitate cardiac dysrhythmias. Uncontrolled reports suggest that continuous positive airway pressure (CPAP) may reduce dysrhythmia frequency and resting heart rate. We undertook a randomised controlled tria...

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Published in:Journal of sleep research 2009-09, Vol.18 (3), p.329-336
Main Authors: CRAIG, SONYA, PEPPERELL, JUSTIN C. T., KOHLER, MALCOLM, CROSTHWAITE, NICKY, DAVIES, ROBERT J. O., STRADLING, JOHN R.
Format: Article
Language:English
Subjects:
Adult
apnoea
Arrhythmias, Cardiac - physiopathology
Arrhythmias, Cardiac - therapy
Circadian Rhythm - physiology
Continuous Positive Airway Pressure
dysrhythmias
Electrocardiography, Ambulatory
Follow-Up Studies
Heart Rate - physiology
Humans
Male
mean heart rate
Middle Aged
obstructive sleep apnoea
Polysomnography
randomised controlled trial
sleep
Sleep Apnea, Obstructive - physiopathology
Sleep Apnea, Obstructive - therapy
Sympathetic Nervous System - physiopathology
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Summary:Summary Obstructive sleep apnoea (OSA) is associated with cardiovascular morbidity and may precipitate cardiac dysrhythmias. Uncontrolled reports suggest that continuous positive airway pressure (CPAP) may reduce dysrhythmia frequency and resting heart rate. We undertook a randomised controlled trial of therapeutic CPAP and compared with a subtherapeutic control which included an exploration of changes in dysrhythmia frequency and heart rate. Values are expressed as mean (SD). Eighty‐three men [49.5 (9.6) years] with moderate–severe OSA [Oxygen Desaturation Index, 41.2 (24.3) dips per hour] underwent 3‐channel 24‐h electrocardiograms during normal daily activities, before and after 1 month of therapeutic (n = 43) or subtherapeutic (n = 40) CPAP. Recordings were manually analysed for mean heart rate, pauses, bradycardias, supraventricular and ventricular dysrhythmias. The two groups were well matched for age, body mass index, OSA severity, cardiovascular risk factors and history. Supraventricular ectopics and ventricular ectopics were frequently found in 95.2% and 85.5% of patients, respectively. Less common were sinus pauses (42.2%), episodes of bradycardia (12%) and ventricular tachycardias (4.8%). Compared with subtherapeutic control, CPAP reduced mean 24‐h heart rate from 83.0 (11.5) to 79.7 (9.8) (P 
ISSN:0962-1105
1365-2869
DOI:10.1111/j.1365-2869.2008.00726.x