Lateral pharyngoplasty reduces nocturnal blood pressure in patients with obstructive sleep apnea

Abstract

Objectives/hypothesis: To compare the values of 24-hour ambulatory blood pressure monitoring (ABPM) in patients with obstructive sleep apnea (OSA), before and after lateral pharyngoplasty, and to investigate the influence of pre- and post-treatment polysomnographic and anthropometric variations on changes in ABPM.

Study design: Prospective study.

Methods: Arterial blood pressure with 24-hour ABPM and nocturnal polysomnography were measured before and 6 months after surgery in 18 consecutively evaluated adults with OSA at a tertiary center.

Results: A total of 83.3% were normotensive patients. Nocturnal measurements showed a decrease of 5.3 mmHg in mean arterial pressure (MAP; P = .01), 7.4 mmHg in mean arterial systolic pressure (SP; P = .006), and 4.2 mmHg in mean arterial diastolic pressure (DP; P = .03), leading to significant reductions in all 24-hour measurements: 3.6 mmHg in MAP, 4.8 mmHg in SP, and 2.9 mmHg in DP. There were also significant mean reductions in the apnea-hypopnea index (AHI), from 33.5 to 20.9 (P = .02), arousal index, from 31.6 to 16.7 (P = .005), and percentage of total sleep time with oxyhemoglobin saturation < 90%, from 10.6% to 0.9% (P = .008). No correlations were noted between the measurements of arterial blood pressure and polysomnographic or anthropometric variations.

Conclusions: In this small case series, lateral pharyngoplasty reduced the values obtained in the 24-hour ABPM due to a significant reduction of blood pressures during sleep in patients with OSA 6 months after surgery. Although the patients presented with reductions in AHI, arousals, and desaturation time, this was not correlated with the improvement in arterial blood pressure.

Keywords: Obstructive sleep apnea; blood pressure; lateral pharyngoplasty; otorhinolaryngological surgical procedures; therapy.