Obstructive Sleep Apnea - Autonomic and Vascular Exploration

Noctural Pulse Waves Variations in OSA as a Predictor of Autonomic and Vascular Response to CPAP Therapy

The goal of this clinical trial is to assess the effect of CPAP withdrawal on vascular and autonomic function in patients with obstructive sleep apnea. The main question it aims to answer is:

• Is the pulse wave amplitude index able to predict the impact of sleep apnea treatment withdrawal (continuous positive airway pressure, CPAP) on endothelial function and baroreflex sensitivity?

Participants will stop using their CPAP for 2 weeks and the investigators will assess vascular and autonomic function before and after the withdrawal. Researchers will compare endothelial and autonomic function at baseline and after 2 weeks of withdrawal to see if there are differences. Moreover, they will assess the association between pulse wave amplitude drop profile and effect of CPAP withdrawal.

Inclusion Criteria:

• Age ≥18 years old
• Diagnosed with OSA (AHI ≥15 events/h), confirmed during screening period
• Adequately treated with CPAP therapy for ≥6 months
• Able to give informed consent as documented by signature

Exclusion Criteria:

• Professional drivers will be excluded from the study because temporary withdrawal of CPAP may induce drowsiness.

• We will also exclude patients with conditions that may affect endothelial and autonomic function:

  • Known Diabetes
  • Known heart failure
  • Known chronic kidney disease
  • Pregnant or lactating women
  • Morbid obesity (≥40 kg/m2)
  • Known Excessive alcohol consumption
  • Known Dementia (especially dementia with Lewy bodies). (61)
  • Patients using alpha and beta blockers
  • Known atrial fibrillation
  • Inability to follow the procedures of the study due to language problems or psychological disorders.