CPAP and Blood Pressure

[BeanMeScot]

My blood pressure had started to creep up a few months ago. I hadn't realized but my doctor was concerned that it was higher than normal for me last time I was there. I started taking it at home and it was higher than it used to be. A month ago I started CPAP. I started noticing that my BP had gone down. I used to be in the 120's on the top number. It had crept into the 130's and stayed there. It wasn't hypertension but it was heading that way. Within a few days of starting CPAP, however, it was back into the 120's. I noticed the change and went back and added the date I started CPAP in the midst of my BP readings. It was an obvious change before and after. Anyone else experience a shift like that? My blood glucose was also getting a little high. Diabetes runs strongly in my family. I am hopeful it has helped push that back down, too.

[Julie]

Hypertension is a 'standard' feature of OSA, so it's natural that yours went down with Cpap, though some people's doesn't (you're lucky, maybe caught it early). It's the major reason for strokes in untreated OSA - and I can't believe no one even mentioned it to you.

[uykucu]

I am so happy to hear this. Not only for you but also for myself, too.
My doctor sent me to sleep study because my blood pressure went up to 160x105 for a period of time. I am so lucky I saw that doctor that day otherwise I would never know I had sleep apnea.
She said sleep apnea is one of the biggest contrubutor to high BP.

Good luck,
uykucu

[SleepyJoeMS]

Antecdotally, for myself as well, this therapy may be reducing my BP too. Diagnosed with "mild" sleep apnea, my research brought out that it is suspected but not certain that this level of impairment is directly linked to hypertension. It seems more definitively linked in moderate and severe cases. My BP suddenly went up to about 137/96 or so (which I would call borderline hypertension according to my research, but my doc didn't), after 25 years of rock solid 120/80. My doc is conservative and put me on a med while waiting the sleep study (he was concerned about the lower number for my age). I should say I work in aviation and require a medical clearance to do my job. The flight surgeon required that I treat my case even though diagnosed as "mild." So the skeptic I am, but having no real choices in the matter (i.e. treating my BP with only meds and not treating my SA) and while going through the usual grieving, denial, acceptance phase of therapy, I've been taking the meds and my BP is under control. However, I just had a follow up with my doc yesterday, and he is happy with the BP, citing the therapy may be helping. He may want to reduce or take me off the meds in a couple of months. I pressed him on the point that the evidence does not show a definitive link between mild SA and BP and that in my case I'm skeptical, and he agreed (I work in a high stress job). But he did describe what happens to your BP during sleep and the mild SA could be having an impact. I don't recall these details, but I'm more open to the possibility that the link is there even for mild cases. I should know more after I eventually come off the meds and see the results of therapy only. If I get there I'll pass on the results over time.

Please do your own research. I can't be sure I didn't misinterpret or get something wrong. These are just my impressions and don't deny the link for more sever SA cases. But it seems you're being treated successfully too. Good for you in your treatment and results!

[Captain_Midnight]

Bean Me asks, re blood pressure normalization w cpap...Anyone else experience a shift like that?

Yes, I did, although it's difficult to quantify as white coat syndrome confounded in-office as well as at-home measurements, early on. My best estimate it that my blood pressure went from about 135-145/95-90 to an average now of 115/65. Now, that's a big difference, but it's been from almost 3 years of totally compliant xpappery. My pulse has also dropped shortly after beginning xpap, and now it's down to 50.

I suspect that for those who've had elevated pressure for a while, the treatment from xpap will be bi-modal. An initial decrease in the first month or two, and then a slower further decline over a few years. All this assumes that OSA hypertensives do everything needed to take good care, meaning avoiding salty foods, too many carbohydrates (including grains), alcohol to excess (either in quantity or frequency), and also watching weight and exercising.

Many OSA patients are "non-dippers" meaning that their bp doesn't go down during sleep. I suspect that I was a non-dipper, and that the transition into deeper sleep with greater vascular relaxation was a slow one for me. I suspect that for some patients, proper pappery slowly reduces nocturnal bp over time; and, that this influences daytime bp. This also might explain the lack of immediate results that some OSA patients hope for.

And, back to your question. Several folks here, and on other OSA forums have reported decreases in bp at varying durations of treatment, and varying levels of normalization.



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[BeanMeScot]

Yes, I did, although it's difficult to quantify as white coat syndrome confounded in-office as well as at-home measurements, early on. My best estimate it that my blood pressure went from about 135-145/95-90 to an average now of 115/65. Now, that's a big difference, but it's been from almost 3 years of totally compliant xpappery. My pulse has also dropped shortly after beginning xpap, and now it's down to 50.

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I have White Coat Syndrome as well. In fact, my BP was quite high when I went in this morning. It's the first thing she said to me when she walked in. But I had been taking my BP at home and I showed her those numbers.

I think doctors think you are lying when you say you have WCS and your BP is only high at the doctor's office but it is true. I can remember going to my pediatrician when I was about 7 or 8 and him being concerned about my BP. My father took me to my chiropractor, who I wasn't afraid of and he checked it. It was fine there.

[Raj]

One small comment on Captain Midnight's post: whole grains -- those not turned into flour -- are slow to digest and have a small glycemic load; very good for you in every way although of course any food eaten in mass quantities isn't healthy.

My BP goes up in the doctor's office, but my cardiologist opined that the blood pressure effects of white-coat anxiety reflect the BP effects of anxiety in general and should be taken as seriously as if the higher reading was constant. I hope he's wrong about this, but it's an interesting viewpoint.

[Captain_Midnight]

Been Me and Raj - -

I've seen a few studies that correlate how we apneics are more frequently gifted with white coat hypertension than is the population at large. Here's the url for one of them... http://tinyurl.com/5uc4u2

One way to picture it is that we've trained sympathetic nervous systems to react easily. If you are like I was a few yrs back, I had a heightened startle reflex. (I would jump at trivial surprise noises.)

WCH does seem to ebb with xpap therapy. My last in office reading was 120/60 a few months back. It will be interesting to see if that holds up.



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[BeanMeScot]

Been Me and Raj - -

I've seen a few studies that correlate how we apneics are more frequently gifted with white coat hypertension than is the population at large. Here's the url for one of them... http://tinyurl.com/5uc4u2

One way to picture it is that we've trained sympathetic nervous systems to react easily. If you are like I was a few yrs back, I had a heightened startle reflex. (I would jump at trivial surprise noises.)

WCH does seem to ebb with xpap therapy. My last in office reading was 120/60 a few months back. It will be interesting to see if that holds up.



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That's interesting. It is actually very difficult to startle me. If I go to the doctor a lot, like a couple of times in a month, my BP gets closer to normal when I am there. The less often I go, the worse it is. You don't even want to know what my BP is at a Gyn office. I got to where I wouldn't even let them take it until I was leaving. If they took it on the way in, they would look at me like I was about to keel over. Of course, with the top number well over 200, that did seem likely.

[Raj]

Interesting indeed, BeanMe, I'd never heard of such a correlation. And Captain, I do in fact have a somewhat exaggerated startle response and also unusually swift reflexes, which might indicate a tendency toward an overly active sympathetic nervous system. I try to encourage my parasympathetic nervous system to dominate through a number of tricks such as breathing strictly through my nose even when exercising, breathing deeply quietly and slowly (when awake), and when feeling tense keeping my exhalation rate slower than my inhalation rate.