Am. J. Respir. Crit. Care Med., Volume 163, Number 2, February 2001, 344-348

Randomized Placebo-controlled Trial of Continuous Positive Airway Pressure on Blood Pressure in the Sleep Apnea-Hypopnea Syndrome

JACQUELINE F. FACCENDA, THOMAS W. MACKAY, NICHOLAS A. BOON, and NEIL J. DOUGLAS

Respiratory Medicine Unit and Cardiovascular Unit, University of Edinburgh, Royal Infirmary, Edinburgh, Scotland, United Kingdom

Arterial blood pressure rises at apnea termination, and there is increasing evidence that the sleep apnea-hypopnea syndrome (SAHS) is associated with daytime hypertension but no randomized controlled trial evidence of whether SAHS treatment reduces blood pressure exists. We, therefore, conducted a randomized placebo-controlled cross-over study of the effects of 4 wk of continuous positive airway pressure (CPAP) or oral placebo on 24-h blood pressure in 68 patients (55 males, 13 females; median apnea-hypopnea index [AHI], 35) not receiving hypotensive medication. Ambulatory blood pressure was recorded for the last 48 h of each treatment. Epworth Sleepiness Score (ESS) and Functional Outcomes of Sleep Questionnaire (FOSQ) were also recorded. All patients were normotensive. There was a small decrease in 24-h diastolic blood pressure (placebo, 79.2 [SE 0.9] mm Hg; CPAP, 77.8 [SE 1.0] mm Hg; p = 0.04) with the greatest fall occurring between 2:00 A.M. and 9:59 A.M. The observed decrease in 24-h diastolic blood pressure was greater in two a priori groups, CPAP use  3.5 h per night (81.5 [SE 1.2] mm Hg; 79.6 [SE 1.2] mm Hg; p = 0.03) and those with more than twenty 4% desaturations per hour (82.4 [SE 2.1] mm Hg; 77.4 [SE 2.1] mm Hg; p = 0.002). Systolic pressure also fell in the latter group (133.1 [SE 2.8] mm Hg; 129.1 [SE 2.1] mm Hg; p = 0.009). Desaturation frequency was the best predictor of diastolic blood pressure fall with CPAP (r = 0.38; p = 0.002). Both ESS and FOSQ domains improved. Thus, CPAP can reduce blood pressure in patients with SAHS, particularly in those with nocturnal oxygen desaturation, but the decrease is small.

This article has been cited by other articles:

				R. L. Riha, T. Gislasson, and K. Diefenbach The phenotype and genotype of adult obstructive sleep apnoea/hypopnoea syndrome Eur. Respir. J., March 1, 2009; 33(3): 646 - 655. [Abstract] [Full Text] [PDF]

				M. Kohler, J. C. T. Pepperell, B. Casadei, S. Craig, N. Crosthwaite, J. R. Stradling, and R. J. O. Davies CPAP and measures of cardiovascular risk in males with OSAS Eur. Respir. J., December 1, 2008; 32(6): 1488 - 1496. [Abstract] [Full Text] [PDF]

				S. A. Chung, H. Yuan, and F. Chung A Systemic Review of Obstructive Sleep Apnea and Its Implications for Anesthesiologists Anesth. Analg., November 1, 2008; 107(5): 1543 - 1563. [Abstract] [Full Text] [PDF]

				N. M. Skjodt Approach to outpatient management of adult sleep apnea Can Fam Physician, October 1, 2008; 54(10): 1408 - 1412. [Abstract] [Full Text] [PDF]

				G V Robinson, B A Langford, D M Smith, and J R Stradling Predictors of blood pressure fall with continuous positive airway pressure (CPAP) treatment of obstructive sleep apnoea (OSA) Thorax, October 1, 2008; 63(10): 855 - 859. [Abstract] [Full Text] [PDF]

				V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF]

				V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF]

				M D Cross, N L Mills, M Al-Abri, R Riha, M Vennelle, T W Mackay, D E Newby, and N J Douglas Continuous positive airway pressure improves vascular function in obstructive sleep apnoea/hypopnoea syndrome: a randomised controlled trial Thorax, July 1, 2008; 63(7): 578 - 583. [Abstract] [Full Text] [PDF]

				M. H. Sanders, J. M. Montserrat, R. Farre, and R. J. Givelber Positive Pressure Therapy: A Perspective on Evidence-based Outcomes and Methods of Application Proceedings of the ATS, February 15, 2008; 5(2): 161 - 172. [Abstract] [Full Text] [PDF]

				T. E. Weaver and R. R. Grunstein Adherence to Continuous Positive Airway Pressure Therapy: The Challenge to Effective Treatment Proceedings of the ATS, February 15, 2008; 5(2): 173 - 178. [Abstract] [Full Text] [PDF]

				M. K. Han, V. V. McLaughlin, G. J. Criner, and F. J. Martinez Pulmonary Diseases and the Heart Circulation, December 18, 2007; 116(25): 2992 - 3005. [Abstract] [Full Text] [PDF]

				B. Buyse, J. Hedner, and the participants of working group 2 Sleep apnoea, hypertension and vascular disease: where are we now? Eur. Respir. Rev., December 1, 2007; 16(106): 169 - 182. [Abstract] [Full Text] [PDF]

				F. Campos-Rodriguez, J. Perez-Ronchel, A. Grilo-Reina, J. Lima-Alvarez, M. A. Benitez, and C. Almeida-Gonzalez Long-term Effect of Continuous Positive Airway Pressure on BP in Patients With Hypertension and Sleep Apnea Chest, December 1, 2007; 132(6): 1847 - 1852. [Abstract] [Full Text] [PDF]

				L. F. Drager, L. A. Bortolotto, A. C. Figueiredo, E. M. Krieger, and G. Lorenzi-Filho Effects of Continuous Positive Airway Pressure on Early Signs of Atherosclerosis in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., October 1, 2007; 176(7): 706 - 712. [Abstract] [Full Text] [PDF]

				W. T. McNicholas Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1666 - R1670. [Abstract] [Full Text] [PDF]

				G. Parati, C. Lombardi, and K. Narkiewicz Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1671 - R1683. [Abstract] [Full Text] [PDF]

				R. K. Kakkar and R. B. Berry Positive Airway Pressure Treatment for Obstructive Sleep Apnea Chest, September 1, 2007; 132(3): 1057 - 1072. [Abstract] [Full Text] [PDF]

				L. A. Bazzano, Z. Khan, K. Reynolds, and J. He Effect of Nocturnal Nasal Continuous Positive Airway Pressure on Blood Pressure in Obstructive Sleep Apnea Hypertension, August 1, 2007; 50(2): 417 - 423. [Abstract] [Full Text] [PDF]

				J. M. Montserrat, F. Garcia-Rio, and F. Barbe Diagnostic and Therapeutic Approach to Nonsleepy Apnea Am. J. Respir. Crit. Care Med., July 1, 2007; 176(1): 6 - 9. [Abstract] [Full Text] [PDF]

				M. Eikermann, A. S. Jordan, N. L. Chamberlin, S. Gautam, A. Wellman, Y.-L. Lo, D. P. White, and A. Malhotra The Influence of Aging on Pharyngeal Collapsibility During Sleep Chest, June 1, 2007; 131(6): 1702 - 1709. [Abstract] [Full Text] [PDF]

				L. A. Smith, M. Vennelle, R. S. Gardner, T. A. McDonagh, M. A. Denvir, N. J. Douglas, and D. E. Newby Auto-titrating continuous positive airway pressure therapy in patients with chronic heart failure and obstructive sleep apnoea: a randomized placebo-controlled trial Eur. Heart J., May 2, 2007; 28(10): 1221 - 1227. [Abstract] [Full Text] [PDF]

				E. R. Chasens Obstructive Sleep Apnea, Daytime Sleepiness, and Type 2 Diabetes The Diabetes Educator, May 1, 2007; 33(3): 475 - 482. [Abstract] [Full Text] [PDF]

				M. A. Martinez-Garcia, R. Gomez-Aldaravi, J-J. Soler-Cataluna, T. G. Martinez, B. Bernacer-Alpera, and P. Roman-Sanchez Positive effect of CPAP treatment on the control of difficult-to-treat hypertension Eur. Respir. J., May 1, 2007; 29(5): 951 - 957. [Abstract] [Full Text] [PDF]

				V. Patruno, S. Aiolfi, G. Costantino, R. Murgia, C. Selmi, A. Malliani, and N. Montano Fixed and Autoadjusting Continuous Positive Airway Pressure Treatments Are Not Similar in Reducing Cardiovascular Risk Factors in Patients With Obstructive Sleep Apnea Chest, May 1, 2007; 131(5): 1393 - 1399. [Abstract] [Full Text] [PDF]

				R. C. Basner Continuous Positive Airway Pressure for Obstructive Sleep Apnea N. Engl. J. Med., April 26, 2007; 356(17): 1751 - 1758. [Full Text] [PDF]

				P. Haentjens, A. Van Meerhaeghe, A. Moscariello, S. De Weerdt, K. Poppe, A. Dupont, and B. Velkeniers The Impact of Continuous Positive Airway Pressure on Blood Pressure in Patients With Obstructive Sleep Apnea Syndrome: Evidence From a Meta-analysis of Placebo-Controlled Randomized Trials Arch Intern Med, April 23, 2007; 167(8): 757 - 764. [Abstract] [Full Text] [PDF]

				S. R. Coughlin, L. Mawdsley, J. A. Mugarza, J. P. H. Wilding, and P. M. A. Calverley Cardiovascular and metabolic effects of CPAP in obese males with OSA Eur. Respir. J., April 1, 2007; 29(4): 720 - 727. [Abstract] [Full Text] [PDF]

				W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26 Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities Eur. Respir. J., January 1, 2007; 29(1): 156 - 178. [Abstract] [Full Text] [PDF]

				M. L. Unruh, M. H. Sanders, S. Redline, B. M. Piraino, J. G. Umans, T. C. Hammond, I. Sharief, N. M. Punjabi, and A. B. Newman Sleep Apnea in Patients on Conventional Thrice-Weekly Hemodialysis: Comparison with Matched Controls from the Sleep Heart Health Study J. Am. Soc. Nephrol., December 1, 2006; 17(12): 3503 - 3509. [Abstract] [Full Text] [PDF]

				C. T. Chan Sleep Apnea with Intermittent Hemodialysis: Time for a Wake-Up Call! J. Am. Soc. Nephrol., December 1, 2006; 17(12): 3279 - 3280. [Full Text] [PDF]

				D S Hui, K W To, F W Ko, J P Fok, M C Chan, J C Ngai, A H Tung, C W Ho, M W Tong, C-C Szeto, et al. Nasal CPAP reduces systemic blood pressure in patients with obstructive sleep apnoea and mild sleepiness Thorax, December 1, 2006; 61(12): 1083 - 1090. [Abstract] [Full Text] [PDF]

				E. R. Chasens and E. Olshansky The Experience of Being Sleepy While Managing Type 2 Diabetes Journal of the American Psychiatric Nurses Association, October 1, 2006; 12(5): 272 - 278. [Abstract] [PDF]

				C-Y Hsu, M Vennelle, H-Y Li, H M Engleman, M S Dennis, and N J Douglas Sleep-disordered breathing after stroke: a randomised controlled trial of continuous positive airway pressure J. Neurol. Neurosurg. Psychiatry, October 1, 2006; 77(10): 1143 - 1149. [Abstract] [Full Text] [PDF]

				F. Campos-Rodriguez, A. Grilo-Reina, J. Perez-Ronchel, M. Merino-Sanchez, M. A. Gonzalez-Benitez, M. Beltran-Robles, and C. Almeida-Gonzalez Effect of Continuous Positive Airway Pressure on Ambulatory BP in Patients With Sleep Apnea and Hypertension: A Placebo-Controlled Trial Chest, June 1, 2006; 129(6): 1459 - 1467. [Abstract] [Full Text] [PDF]

				G. V. Robinson, D. M. Smith, B. A. Langford, R. J. O. Davies, and J. R. Stradling Continuous positive airway pressure does not reduce blood pressure in nonsleepy hypertensive OSA patients Eur. Respir. J., June 1, 2006; 27(6): 1229 - 1235. [Abstract] [Full Text] [PDF]

				N T Ayas, G B J Mancini, and J Fleetham Does CPAP delay the development of cardiovascular disease in patients with obstructive sleep apnoea hypopnoea? Thorax, June 1, 2006; 61(6): 459 - 460. [Full Text] [PDF]

				N. T. Ayas, J. M. FitzGerald, J. A. Fleetham, D. P. White, M. Schulzer, C. F. Ryan, R. Ghaeli, G. W. Mercer, P. Cooper, M. C. Y. Tan, et al. Cost-effectiveness of Continuous Positive Airway Pressure Therapy for Moderate to Severe Obstructive Sleep Apnea/Hypopnea. Arch Intern Med, May 8, 2006; 166(9): 977 - 984. [Abstract] [Full Text] [PDF]

				D. Norman, J. S. Loredo, R. A. Nelesen, S. Ancoli-Israel, P. J. Mills, M. G. Ziegler, and J. E. Dimsdale Effects of Continuous Positive Airway Pressure Versus Supplemental Oxygen on 24-Hour Ambulatory Blood Pressure Hypertension, May 1, 2006; 47(5): 840 - 845. [Abstract] [Full Text] [PDF]

				C. L. Bassetti, M. Milanova, and M. Gugger Sleep-Disordered Breathing and Acute Ischemic Stroke: Diagnosis, Risk Factors, Treatment, Evolution, and Long-Term Clinical Outcome Stroke, April 1, 2006; 37(4): 967 - 972. [Abstract] [Full Text] [PDF]

				P. Elwood, M. Hack, J. Pickering, J. Hughes, and J. Gallacher Sleep disturbance, stroke, and heart disease events: evidence from the Caerphilly cohort J Epidemiol Community Health, January 1, 2006; 60(1): 69 - 73. [Abstract] [Full Text] [PDF]

				D. P. White Sleep apnea. Proceedings of the ATS, January 1, 2006; 3(1): 124 - 128. [Abstract] [Full Text] [PDF]

				A. I. Pack Advances in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 7 - 15. [Abstract] [Full Text] [PDF]

				C. Selic, M. M. Siccoli, D. M. Hermann, and C. L. Bassetti Blood Pressure Evolution After Acute Ischemic Stroke in Patients With and Without Sleep Apnea Stroke, December 1, 2005; 36(12): 2614 - 2618. [Abstract] [Full Text] [PDF]

				L J Cormican and A Williams Sleep disordered breathing and its treatment in congestive heart failure Heart, October 1, 2005; 91(10): 1265 - 1270. [Abstract] [Full Text] [PDF]

				Y. Huang, D. P. White, and A. Malhotra The Impact of Anatomic Manipulations on Pharyngeal Collapse: Results From a Computational Model of the Normal Human Upper Airway Chest, September 1, 2005; 128(3): 1324 - 1330. [Abstract] [Full Text] [PDF]

				F. Campos-Rodriguez, N. Pena-Grinan, N. Reyes-Nunez, I. De la Cruz-Moron, J. Perez-Ronchel, F. De la Vega-Gallardo, and A. Fernandez-Palacin Mortality in Obstructive Sleep Apnea-Hypopnea Patients Treated With Positive Airway Pressure Chest, August 1, 2005; 128(2): 624 - 633. [Abstract] [Full Text] [PDF]

				M. S. Aloia, M. Stanchina, J. T. Arnedt, A. Malhotra, and R. P. Millman Treatment Adherence and Outcomes in Flexible vs Standard Continuous Positive Airway Pressure Therapy Chest, June 1, 2005; 127(6): 2085 - 2093. [Abstract] [Full Text] [PDF]

				E. R. Chasens, A. I. Pack, G. Maislin, D. F. Dinges, and T. E. Weaver Claustrophobia and Adherence to CPAP Treatment West J Nurs Res, April 1, 2005; 27(3): 307 - 321. [Abstract] [PDF]

				P Gordon and M H Sanders Sleep {middle dot} 7: Positive airway pressure therapy for obstructive sleep apnoea/hypopnoea syndrome Thorax, January 1, 2005; 60(1): 68 - 75. [Abstract] [Full Text] [PDF]

				G V Robinson, J R Stradling, and R J O Davies Sleep {middle dot} 6: Obstructive sleep apnoea/hypopnoea syndrome and hypertension Thorax, December 1, 2004; 59(12): 1089 - 1094. [Abstract] [Full Text] [PDF]

				M. Barnes, R. D. McEvoy, S. Banks, N. Tarquinio, C. G. Murray, N. Vowles, and R. J. Pierce Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., September 15, 2004; 170(6): 656 - 664. [Abstract] [Full Text] [PDF]

				M.R. Wild, H.M. Engleman, N.J. Douglas, and C.A. Espie Can psychological factors help us to determine adherence to CPAP? A prospective study Eur. Respir. J., September 1, 2004; 24(3): 461 - 465. [Abstract] [Full Text] [PDF]

				G V Robinson, J C T Pepperell, H C Segal, R J O Davies, and J R Stradling Circulating cardiovascular risk factors in obstructive sleep apnoea: data from randomised controlled trials Thorax, September 1, 2004; 59(9): 777 - 782. [Abstract] [Full Text] [PDF]

				J. M. Parish and V. K. Somers Obstructive Sleep Apnea and Cardiovascular Disease Mayo Clin. Proc., August 1, 2004; 79(8): 1036 - 1046. [Abstract] [PDF]

				K. M. Oltmanns, H. Gehring, S. Rudolf, B. Schultes, S. Rook, U. Schweiger, J. Born, H. L. Fehm, and A. Peters Hypoxia Causes Glucose Intolerance in Humans Am. J. Respir. Crit. Care Med., June 1, 2004; 169(11): 1231 - 1237. [Abstract] [Full Text] [PDF]

				S. Javaheri, W. T. Abraham, C. Brown, H. Nishiyama, R. Giesting, and L. E. Wagoner Prevalence of obstructive sleep apnoea and periodic limb movement in 45 subjects with heart transplantation Eur. Heart J., February 1, 2004; 25(3): 260 - 266. [Abstract] [Full Text] [PDF]

				J. Heitmann, K. Ehlenz, T. Penzel, H.F. Becker, L. Grote, K.H. Voigt, J. Hermann Peter, and C. Vogelmeier Sympathetic activity is reduced by nCPAP in hypertensive obstructive sleep apnoea patients Eur. Respir. J., February 1, 2004; 23(2): 255 - 262. [Abstract] [Full Text] [PDF]

				J. Stradling Con: Sleep Apnea Does Not Cause Cardiovascular Disease Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 148 - 149. [Full Text] [PDF]

				J Fleetham Sleep disordered breathing awoken Thorax, January 1, 2004; 59(1): 5 - 6. [Full Text] [PDF]

				J R Stradling and R J O Davies Sleep {middle dot} 1: Obstructive sleep apnoea/hypopnoea syndrome: definitions, epidemiology, and natural history Thorax, January 1, 2004; 59(1): 73 - 78. [Abstract] [Full Text] [PDF]

				G. Sampol, O. Romero, A. Salas, J. L. Tovar, P. Lloberes, T. Sagales, and A. Evangelista Obstructive Sleep Apnea and Thoracic Aorta Dissection Am. J. Respir. Crit. Care Med., December 15, 2003; 168(12): 1528 - 1531. [Abstract] [Full Text] [PDF]

				R. Wolk, A. S.M. Shamsuzzaman, and V. K. Somers Obesity, Sleep Apnea, and Hypertension Hypertension, December 1, 2003; 42(6): 1067 - 1074. [Abstract] [Full Text] [PDF]

				A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr, D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright Jr, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Hypertension, December 1, 2003; 42(6): 1206 - 1252. [Abstract] [Full Text] [PDF]

				G V Robinson, J C Pepperell, R J O Davies, and J R Stradling Caffeine levels following treatment of obstructive sleep apnoea Thorax, September 1, 2003; 58(9): 801 - 802. [Abstract] [Full Text] [PDF]

				T. V. Cloward, J. M. Walker, R. J. Farney, and J. L. Anderson Left Ventricular Hypertrophy Is a Common Echocardiographic Abnormality in Severe Obstructive Sleep Apnea and Reverses With Nasal Continuous Positive Airway Pressure Chest, August 1, 2003; 124(2): 594 - 601. [Abstract] [Full Text] [PDF]

				Y. Kaneko, J. S. Floras, K. Usui, J. Plante, R. Tkacova, T. Kubo, S.-i. Ando, and T. D. Bradley Cardiovascular Effects of Continuous Positive Airway Pressure in Patients with Heart Failure and Obstructive Sleep Apnea N. Engl. J. Med., March 27, 2003; 348(13): 1233 - 1241. [Abstract] [Full Text] [PDF]

				S. R. Patel, D. P. White, A. Malhotra, M. L. Stanchina, and N. T. Ayas Continuous Positive Airway Pressure Therapy for Treating gess in a Diverse Population With Obstructive Sleep Apnea: Results of a Meta-analysis Arch Intern Med, March 10, 2003; 163(5): 565 - 571. [Abstract] [Full Text] [PDF]

				O. Marrone, A. Salvaggio, M.R. Bonsignore, G. Insalaco, and G. Bonsignore Blood pressure responsiveness to obstructive events during sleep after chronic CPAP Eur. Respir. J., March 1, 2003; 21(3): 509 - 514. [Abstract] [Full Text] [PDF]

				A.G. Logan, R. Tkacova, S.M. Perlikowski, R.S. Leung, A. Tisler, J.S. Floras, and T.D. Bradley Refractory hypertension and sleep apnoea: effect of CPAP on blood pressure and baroreflex Eur. Respir. J., February 1, 2003; 21(2): 241 - 247. [Abstract] [Full Text] [PDF]

				A. I. Pack Should a Pharmaceutical Be Approved for the Broad Indication of Excessive Sleepiness? Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 109 - 111. [Full Text] [PDF]

				B. Izci, R. L. Riha, S. E. Martin, M. Vennelle, W. A. Liston, K. C. Dundas, A. A. Calder, and N. J. Douglas The Upper Airway in Pregnancy and Pre-Eclampsia Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 137 - 140. [Abstract] [Full Text] [PDF]

				H. F. Becker, A. Jerrentrup, T. Ploch, L. Grote, T. Penzel, C. E. Sullivan, and J. H. Peter Effect of Nasal Continuous Positive Airway Pressure Treatment on Blood Pressure in Patients With Obstructive Sleep Apnea Circulation, January 7, 2003; 107(1): 68 - 73. [Abstract] [Full Text] [PDF]

				C. A. Massie, N. McArdle, R. W. Hart, W. W. Schmidt-Nowara, A. Lankford, D. W. Hudgel, N. Gordon, and N. J. Douglas Comparison between Automatic and Fixed Positive Airway Pressure Therapy in the Home Am. J. Respir. Crit. Care Med., January 1, 2003; 167(1): 20 - 23. [Abstract] [Full Text] [PDF]

				W.T. McNicholas and J. Krieger on behalf of the Ta and Members of the Task Force: W.T. McNicholas , P. Le Public health and medicolegal implications of sleep apnoea Eur. Respir. J., December 1, 2002; 20(6): 1594 - 1609. [Full Text] [PDF]

				M. Alchanatis, G. Tourkohoriti, E.N. Kosmas, G. Panoutsopoulos, S. Kakouros, K. Papadima, M. Gaga, and J.B. Jordanoglou Evidence for left ventricular dysfunction in patients with obstructive sleep apnoea syndrome Eur. Respir. J., November 1, 2002; 20(5): 1239 - 1245. [Abstract] [Full Text] [PDF]

				S. T. Kuna A 54-Year-Old Man With Obstructive Sleep Apnea JAMA, October 23, 2002; 288(16): 2032 - 2039. [Full Text] [PDF]

				N. A. Collop Silent Bedpartners : Obstructive Sleep Apnea and Hypertension, 6 Years Later Chest, October 1, 2002; 122(4): 1111 - 1112. [Full Text] [PDF]

				K. M. Hla, J. B. Skatrud, L. Finn, M. Palta, and T. Young The Effect of Correction of Sleep-Disordered Breathing on BP in Untreated Hypertension Chest, October 1, 2002; 122(4): 1125 - 1132. [Abstract] [Full Text] [PDF]

				D. S.C. Hui, D. K.L. Choy, L. K.S. Wong, F. W.S. Ko, T. S.T. Li, J. Woo, and R. Kay Prevalence of Sleep-Disordered Breathing and Continuous Positive Airway Pressure Compliance* : Results in Chinese Patients With First-Ever Ischemic Stroke Chest, September 1, 2002; 122(3): 852 - 860. [Abstract] [Full Text] [PDF]

				M. R. Bonsignore, G. Parati, G. Insalaco, O. Marrone, P. Castiglioni, S. Romano, M. Di Rienzo, G. Mancia, and G. Bonsignore Continuous Positive Airway Pressure Treatment Improves Baroreflex Control of Heart Rate during Sleep in Severe Obstructive Sleep Apnea Syndrome Am. J. Respir. Crit. Care Med., August 1, 2002; 166(3): 279 - 286. [Abstract] [Full Text] [PDF]

				S. Boyer and V. Kapur Obstructive Sleep Apnea: Its Relevance in the Care of Diabetic Patients Clin. Diabetes, July 1, 2002; 20(3): 126 - 132. [Abstract] [Full Text] [PDF]

				T. Young, P. E. Peppard, and D. J. Gottlieb Epidemiology of Obstructive Sleep Apnea: A Population Health Perspective Am. J. Respir. Crit. Care Med., May 1, 2002; 165(9): 1217 - 1239. [Abstract] [Full Text] [PDF]

				H. M. Engleman When Does `Mild' Obstructive Sleep Apnea/Hypopnea Syndrome Merit Continuous Positive Airway Pressure Treatment? Am. J. Respir. Crit. Care Med., March 15, 2002; 165(6): 743 - 745. [Full Text] [PDF]

				M. BARNES, D. HOUSTON, C. J. WORSNOP, A. M. NEILL, I. J. MYKYTYN, A. KAY, J. TRINDER, N. A. SAUNDERS, R. D. MCEVOY, and R. J. PIERCE A Randomized Controlled Trial of Continuous Positive Airway Pressure in Mild Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., March 15, 2002; 165(6): 773 - 780. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Sleep-Disordered Breathing, Control of Breathing, Respiratory Muscles, and Pulmonary Function Testing in AJRCCM 2001 Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 584 - 597. [Full Text] [PDF]

				N. J. Douglas, H. M. Engleman, J. F. Faccenda, and N. McArdle THE SCIENCE OF DESIGNING ETHICAL CPAP TRIALS Am. J. Respir. Crit. Care Med., January 1, 2002; 165(1): 132a - 134. [Full Text] [PDF]

				N J Douglas and C F P George Treating sleep apnoea is cost effective Thorax, January 1, 2002; 57(1): 93 - 93. [Full Text] [PDF]

				R. S. T. LEUNG and T. DOUGLAS BRADLEY Sleep Apnea and Cardiovascular Disease Am. J. Respir. Crit. Care Med., December 15, 2001; 164(12): 2147 - 2165. [Full Text] [PDF]

				J R Stradling, J C T Pepperell, and R J O Davies Sleep apnoea and hypertension: proof at last? Thorax, September 1, 2001; 56(90002): ii45 - 49. [Full Text] [PDF]