Sleep-Wake Disorders

CPAP Does Not Change B Natriuretic Peptide Levels in OSA-Hypopnea Syndrome

Lisa Kuhns, PhD
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The study found that variations in clinical characteristics among patients with OSA-hypopnea syndrome were not associated with changes in BNP levels.

Continuous positive airway pressure (CPAP) therapy in patients obstructive sleep apnea-hypopnea syndrome (OSAHS) does not change B natriuretic peptide (BNP) levels, suggesting that BNP is not useful as an index to evaluate heart function in these patients. These were among meta-analysis findings reported in BMC Pulmonary Medicine.

Researchers conducted a review and meta-analysis to determine whether CPAP for OSAHS affected patients’ levels of B natriuretic peptide, a diagnostic marker for heart disease. The reviewers searched for relevant research in the PubMed, EMBASE, Google Scholar, and Web of Science databases from inception until October 24, 2022.

The meta-analysis included 8 articles comprising 11 studies with approximately 400 individuals. In the pooled analysis, CPAP therapy did not significantly change the BNP level of patients with OSAHS. The weighted mean difference (WMD) was -0.47 (95% CI, -1.67-2.62) based on the random effects model due to high heterogeneity among the studies.

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Our meta-analysis suggests that CPAP therapy will not change the BNP level in patients with OSAHS; therefore, it is not accurate to use BNP level as an index to evaluate heart function in patients with OSAHS…

A subgroup analysis was also explored but found no significant changes in the BNP levels of patients with OSAHS. According to study authors, this indicated that “changes in clinical characteristics will not affect the changes in BNP levels in patients with OSAHS.” The Begg’s (P =.835) and Egger’s tests (P =.245) showed no publication bias.

This study was limited by lack of participant data on key factors affecting OSA, including body mass index, apnea-hypopnea index scores, age, sex, and CPAP time. Additionally, there was a potential for bias due to different susceptibility and measurement methods for BNP used between the studies.

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The study authors concluded, “Our meta-analysis suggests that CPAP therapy will not change the BNP level in patients with OSAHS; therefore, it is not accurate to use BNP level as an index to evaluate heart function in patients with OSAHS, but more related research should be conducted.”

This article originally appeared on Pulmonology Advisor

References:

Wu, Q., Ma, X., Wang, Y. et al. Efficacy of continuous positive airway pressure on NT-pro-BNP in obstructive sleep apnea patients: a meta-analysis. BMC Pulm Med. Published online July 13, 2023. doi.org/10.1186/s12890-023-02539-9