Changes in sleepiness and 24-h blood pressure following 4 months of CPAP treatment are not mediated by ICAM-1

• Published in: Sleep & breathing Vol. 25; no. 3; pp. 1495 - 1502
• Main Authors: Pak, Victoria M., Maislin, David G., Keenan, Brendan T., Townsend, Raymond R., Benediktsdottir, Bryndis, Dunbar, Sandra B., Pack, Allan I., Gislason, Thorarinn, Kuna, Samuel T.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2021; Springer Nature B.V
• Subjects: Adult; Aged; Antihypertensives; Apnea; Blood pressure; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Body mass index; Cell adhesion; Continuous positive airway pressure; Continuous Positive Airway Pressure - statistics & numerical data; Dentistry; Female; Follow-Up Studies; Humans; Intercellular adhesion molecule 1; Intercellular Adhesion Molecule-1 - metabolism; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Otorhinolaryngology; Pediatrics; Physical activity; Pneumology/Respiratory System; Regression analysis; Sleep and wakefulness; Sleep apnea; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - therapy; Sleep Breathing Physiology and Disorders • Original Article; Sleep deprivation; Sleep disorders; Sleepiness - physiology; Statistical analysis; Treatment Outcome; Vigilance; Continuous positive airway pressure; Obstructive sleep apnea; Sleepiness; Intercellular adhesion molecule-1; Ambulatory blood pressure monitoring
• ISSN: 1520-9512; 1522-1709; 1522-1709
• DOI: 10.1007/s11325-020-02257-0

Objective Continuous positive airway pressure (CPAP) therapy reduces circulating intercellular adhesion molecule 1 (ICAM-1) in adults with obstructive sleep apnea (OSA). ICAM-1 levels may affect the daytime sleepiness and elevated blood pressure associated with OSA. We evaluated the association of changes from baseline in ICAM-1 with changes of objective and subjective measures of sleepiness, as well as 24-h ambulatory blood pressure monitoring (ABPM) measures, following 4 months of CPAP treatment. Methods The study sample included adults with newly diagnosed OSA. Plasma ICAM-1, 24-h ABPM, Epworth Sleepiness Scale (ESS), and psychomotor vigilance task (PVT) were obtained at baseline and following adequate CPAP treatment. The associations between changes in natural log ICAM-1 and changes in the number of lapses on PVT, ESS score, and 24-h mean arterial blood pressure (MAP) were assessed using multivariate regression models, controlling for a priori baseline covariates of age, sex, BMI, race, site, smoking status, physical activity, anti-hypertensive medications, AHI, and daily hours of CPAP use. Results Among 140 adults (83% men), mean (± SD) body mass index (BMI) was 31.5 ± 4.2 kg/m 2 , and apnea-hyopnea index (AHI) was 36.8 ± 15.3 events/h. Sleepiness measures, although not ICAM-1 or ABPM measures, improved significantly following CPAP treatment. We observed no statistically significant associations between the change in ICAM-1 and changes in sleepiness, MAP, or other ABPM measures. Conclusion Changes in ICAM-1 levels were not related to changes in sleepiness or ABPM following CPAP treatment of adults with OSA. Future work should explore whether or not other biomarkers may have a role in mediating these treatment outcomes in adults with OSA.