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Auto-adaptive positive airway pressure improves lung function and arterial stiffness parameters in patients with severe obstructive sleep apnea syndrome over a 1 year follow-up

Objective: Auto-adaptive positive airway pressure (APAP)is an emerging therapeutic modality for obstructive sleep apnea (OSA) patients. However, their associated physiological effects have not been well- defined. Therefore, we aimed to investigate the impact of a 1 year APAP treatment on lung function and arterial stiffness parameters. Approach: This study enrolled male patients with newly diagnosed severe OSA who have undergone APAP treatment. A total of 35 patients completed a 1 year follow up. Blood pressure, arterial stiffness(PWV, cAIx, pAIx, cSBP), and lung function readings (FEV1, FVC, FEV1/FVC, PEF)were obtained basally and after 1, 3, 6, and 12 months of treatment. Main results: A gradual increase in FEV1 has been observed over the follow-up (2.92 ± 0.88 versus 3.07 ± 0.92 versus 3.18 ± 0.93 versus 3.28 ± 0.93 versus 3.41 ± 0.97 L), while PWV showed a gradual decrease over the follow-up (9.72 ± 1.64 versus 9.32 ± 1.73 versus 8.89 ± 1.65 versus 8.53 ± 1.61 versus 8.46 ± 1.60 m s−1 ), as measured by absolute values. Linear mixed effects model analysis revealed a statistically significantly higher FEV1 values(coefficient of 0.11, 0.20, and 0.33 for 3rd month, 6th month, and 12th month, respectively, P < 0.001) and lower PWV values(coefficient of −0.69, −0.63, and −0.34 for 3rd month, 6th month, and 12th month, respectively, P < 0.001), after the initiation of APAP treatment. Significance: We conclude that APAP treatment improves main lung function and arterial stiffness parameters in male patients with severe OSA over a 1 year follow-up.

APAP, obstructive sleep apnea, pulse wave velocity, blood pressure, end-organ damage, lung function

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