Influence of treatment on muscle sympathetic nerve activity in sleep apnea

Neil V. Waravdekar, Lawrence I. Sinoway, Clifford W. Zwillich, Urs A. Leuenberger

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196 Scopus citations


Obstructive sleep apnea (OSA) is a common disorder associated with systemic hypertension, myocardial infarction, stroke, and premature death. Elevated sympathetic tone has been documented previously in OSA and may contribute to the cardiovascular risk. As OSA therapy appears to reduce mortality, we wondered if decreased apnea activity would attenuate the sympathetic hyperactivity of untreated patients. Muscle sympathetic nerve activity (MSNA) was measured during wakefulness via peroneal microneurography in seven patients with documented OSA before and at least 1 mo after compliance-monitored nasal continuous positive airway pressure (CPAP) therapy. Before institution of CPAP therapy, MSNA was high in all patients and decreased after CPAP therapy (baseline versus CPAP: 69.4 ± 15.3 versus 53.9 ± 10.5 bursts/min, mean ± SD; p < 0.01). However, the decrease in MSNA was limited to the four patients with the greatest nightly use of CPAP (≥ 4.5 h/night), whereas it remained unchanged in the three patients who were less compliant. There was a direct linear correlation between the decrease in MSNA (bursts/min) and the average hours of CPAP use per night (r = 0.87, p = 0.01). We conclude that in patients with OSA effective reduction in apnea activity with CPAP therapy diminishes the high sympathetic tone present during resting wakefulness.

Original languageEnglish (US)
Pages (from-to)1333-1338
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Issue number4
StatePublished - 1996

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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