Changes in sleepiness and 24-h blood pressure following 4 months of CPAP treatment are not mediated by ICAM-1.
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AuthorsPak, Victoria M
Maislin, David G
Keenan, Brendan T
Townsend, Raymond R
Dunbar, Sandra B
Pack, Allan I
Kuna, Samuel T
MetadataShow full item record
CitationPak VM, Maislin DG, Keenan BT, Townsend RR, Benediktsdottir B, Dunbar SB, et al. Changes in sleepiness and 24-h blood pressure following 4 months of CPAP treatment are not mediated by ICAM-1. Sleep & breathing = Schlaf & Atmung. 2021.doi:10.1007/s11325-020-02257-0.
AbstractObjective: Continuous positive airway pressure (CPAP) therapy reduces circulating intercellular adhesion molecule 1 (ICAM-1) in adults with obstructive sleep apnea (OSA). ICAM-1 levels may affect the daytime sleepiness and elevated blood pressure associated with OSA. We evaluated the association of changes from baseline in ICAM-1 with changes of objective and subjective measures of sleepiness, as well as 24-h ambulatory blood pressure monitoring (ABPM) measures, following 4 months of CPAP treatment. Methods: The study sample included adults with newly diagnosed OSA. Plasma ICAM-1, 24-h ABPM, Epworth Sleepiness Scale (ESS), and psychomotor vigilance task (PVT) were obtained at baseline and following adequate CPAP treatment. The associations between changes in natural log ICAM-1 and changes in the number of lapses on PVT, ESS score, and 24-h mean arterial blood pressure (MAP) were assessed using multivariate regression models, controlling for a priori baseline covariates of age, sex, BMI, race, site, smoking status, physical activity, anti-hypertensive medications, AHI, and daily hours of CPAP use. Results: Among 140 adults (83% men), mean (± SD) body mass index (BMI) was 31.5 ± 4.2 kg/m2, and apnea-hyopnea index (AHI) was 36.8 ± 15.3 events/h. Sleepiness measures, although not ICAM-1 or ABPM measures, improved significantly following CPAP treatment. We observed no statistically significant associations between the change in ICAM-1 and changes in sleepiness, MAP, or other ABPM measures. Conclusion: Changes in ICAM-1 levels were not related to changes in sleepiness or ABPM following CPAP treatment of adults with OSA. Future work should explore whether or not other biomarkers may have a role in mediating these treatment outcomes in adults with OSA. Keywords: Ambulatory blood pressure monitoring; Continuous positive airway pressure; Intercellular adhesion molecule-1; Obstructive sleep apnea; Sleepiness.
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