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CPAP reverses brain stem changes associated with MSNA in patients with OSA

Continuous positive airway pressure treatment for 6 months significantly reduced elevated muscle sympathetic nerve activity and the associated brain stem functional and anatomical changes in patients with obstructive sleep apnea, according to study results.

Linda C. Lundblad, PhD, a clinical neurophysiology technologist at Sahlgrenska University Hospital in Sweden, and colleagues recruited 13 adults with obstructive sleep apnea and 15 healthy control participants to assess if treatment of the sleep disorder with continuous positive airway pressure would reduce the elevated muscle sympathetic nerve activity and reverse the brain stem functional changes associated with the nerve activity.

Six months of continuous positive airway pressure (CPAP) therapy appeared to significantly reduce muscle sympathetic nerve activity (MSNA) in patients with obstructive sleep apnea (OSA) from 54 to 23 bursts per minute (P < .0001) and from 77 to 36 bursts per 100 heart beats (P = .003).

Brain cell activity in the medullary raphe (P = .04), left RVLM (P = .02) and left dorsolateral pons (P = .006) all increased significantly in patients with OSA after 6 months of treatment. The levels in patients treated with CPAP came within distance of the medullary raphe (P = .27), left RVLM (P = .22) and left dorsolateral pons (P = .09) levels in the healthy participants.

“These data show that the underlying mechanisms responsible for elevated MSNA in OSA are indeed reversible and highlight the effectiveness of CPAP treatment in reducing [cardiovascular disease] associated with OSA,” the researchers wrote.  

Disclosure: The researchers report no relevant financial disclosures.