Fixed PAP vs APAP: Impact on Blood Pressure and Autonomic Response

About this episode

This episode discusses the impact of fixed CPAP versus APAP on blood pressure and autonomic response with experts in the field.

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Abhishek Goyal, Professor and Head of Respiratory Medicine in Dehradoon, India, and Dr. Prakhar Agarwal, a pulmonologist in private practice in Bhopal, India, to discuss their research comparing fixed CPAP versus auto-titrating CPAP (APAP) on blood pressure control and autonomic nervous system response. For years, difficult-to-treat hypertension has been recognized as an indication for sleep studies, reflecting the assumption that treating sleep apnea improves blood pressure. But does the method of PAP therapy matter? Beyond achieving a residual AHI under 5, are there treatment nuances that could optimize cardiovascular outcomes? Dr. Goyal and Dr. Agarwal's research addresses these questions, building on landmark work by Dr. Pepin examining fixed versus auto-titrating PAP therapy. The motivation includes both clinical and economic considerations. A 2021 Portuguese study examined cost implications, and similar economic pressures exist in India where APAP is significantly more expensive than fixed CPAP. The study used a crossover design comparing fixed CPAP to APAP, measuring blood pressure dipping patterns and…

People in this episode

Host: Dr. Seema Khosla

Guests: Dr. Abhishek Goyal, Dr. Prakhar Agarwal

Topics covered

• PAP therapy
• blood pressure
• autonomic response
• sleep apnea
• hypertension
• clinical research

Keywords

• CPAP
• APAP
• blood pressure control
• autonomic nervous system
• hypertension
• sleep studies
• cardiovascular outcomes

Mentioned in this episode

Organizations: AASM, Portuguese study

Places: Dehradoon, India, Bhopal, India

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