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Updated: Jun 4, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Antihypertensive therapy for patients with obstructive sleep apnea
Michael G Ziegler1, Milos Milic, Ping Sun
1University of California San Diego, San Diego, California 92103-8341, USA. mziegler@ucsd.edu
Obstructive sleep apnea (OSA) is linked to difficult-to-control hypertension. Specific therapies like beta-blockers, ACE inhibitors, and spironolactone show promise for managing OSA-related high blood pressure.
Area of Science:
- Cardiology
- Nephrology
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) frequently co-occurs with hypertension, often proving resistant to standard treatments.
- Metabolic syndrome and renal insufficiency are common comorbidities in patients with OSA.
Purpose of the Study:
- To review the underlying causes of hypertension in OSA patients.
- To evaluate the evidence for various therapeutic interventions in managing OSA-related hypertension.
Main Methods:
- Literature review of studies investigating the relationship between OSA and hypertension.
- Analysis of physiological mechanisms linking sleep apnea to elevated blood pressure.
- Synthesis of clinical trial data on antihypertensive drug efficacy in OSA.
Main Results:
- Apneas trigger sustained daytime sympathetic nerve activity and atrial natriuretic peptide release.
- Beta-1 adrenergic blockers demonstrated greater efficacy than thiazide diuretics in OSA.
- Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers showed comparable effectiveness.
- Spironolactone proved beneficial for patients with treatment-resistant hypertension and OSA.
Conclusions:
- Patients with OSA exhibit distinct responses to antihypertensives compared to the general elderly population.
- Beta-1 blockers, ACE inhibitors, and angiotensin II blockers are effective in OSA.
- Spironolactone is a valuable option for refractory hypertension in OSA patients.
- Administering shorter-acting antihypertensives at night may help manage nocturnal hypertension.
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