Effects Of Positive Airway Pressure Treatment On Pulmonary Artery Pressure In Patients With Severe Obstructive Sleep Apnea/hypopnea Syndrome

ObjectiveTo investigate if there is pulmonary hypertension (PH) in patients with severe obstructive sleep apnea /hypopnea syndrome (OSAS) and to evaluate the effects of two different positive airway pressure treatments, namely continuous positive airway pressure (CPAP) and Bi-level positive airway pressure (BiPAP) treatments, on pulmonary arterial pressure(P_PA) in OSAS patients.MethodsFourteen severe OSAS patients without cardiac or lung diseases were recruited and were divided into two groups, CPAP group(seven patients) and BiPAP group(seven patients) based on the method of positive airway pressure they received. Pulsed-wave doppler echocardiography was used for estimation of their P_PA. P_PAwas compared before and after 6-months' treatment in all patients as well as between two groups.ResultsOf all severe fourteen OSAS patients mild PH were detected in five patients ( 35.7% ) . After 6-months' positive airway treatment, the P_PA in fourteen OSAS patients was significantly lower than that before treatments (29.6±7.2 mm Hg vs 26.0±5.0 mm Hg, P < 0.05 ) . Comparison of P_PA before and after different positive pressure treatment between the two groups demonstrated that in CPAP group, although there seemed a tendency of decrease in P_PA after CPAP treatment, no statistical significance was reached( 29.0±6.6 mm Hg vs 27.7±5.9 mm Hg,P > 0.05 ); however, in BiPAP group there was a significant decrease in P_PA after BiPAP treatment, compared with that before treatment (30.1±8.3 mm Hg vs 24.3±3.6 mm Hg, P < 0.05 ) .ConclusionPH may occur in severe OSAS patients. The P_PA in OSAS patients can be decreased by BiPAP treatment which is favorable for treatment and prevention of PH in OSAS patients.