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chris_w
Unread post  Post subject: Question for TheLankyLefty about blood pressure!  |  Posted: Tue Jan 10, 2017 11:22 pm

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Hi all,


Jason (or anyone else who has seen data),


Have you ever measured BP in a patient during a sleep study during and/or after apnea events? I am curious what you saw.


Thanks in advance!


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TheLankyLefty
Unread post  Post subject: Re: Question for TheLankyLefty about blood pressure!  |  Posted: Wed Jan 11, 2017 11:17 pm
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I haven't measured this. It would certainly wake the patient if their arm were being squeezed during sleep.

During apnea events the heart rate increases AND oxygenation of the blood decreases. This is a very important point.

If you're exercising and breathing, the heart rate goes up, but your blood pressure stays relatively the same because your vessels dilate.

During sleep if you stop breathing, your heart rate increases and your blood vessels constrict to assist in getting what little O2 in your bloodstream to your brain and lungs. BP goes up.

Never been asked that question before! :)

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chris_w
Unread post  Post subject: Re: Question for TheLankyLefty about blood pressure!  |  Posted: Thu Jan 12, 2017 5:19 am

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Thanks, Jason!


I asked that because I've been wondering how much apnea tends to affect BP, how quickly the rise begins and how long it takes for the rise to decay.


I came across a study (I'll link you if you're interested) where the researchers noted that BP follows OSA's even in the absence of hypoxemia. They wanted to determine whether the rise in BP was due to changes in intrathoracic pressure, arousal, or the resumption of inhalation.

The researchers recorded all the usuals including BP and esophageal pressure.

First they caused OSA's during Stage 2 NREM, and released the OSA's at the same time the patient/test subjects registered arousal. BP went up by 15-25 mm Hg.


Then for the next test mode they had the patients essentially recreate those apneas while they were awake, by observing the traces for esophageal pressure measured when they were asleep, and matching those traces in realtime by doing a Mueller maneuver. BP only went up 1-10 mm Hg.


Then they repeated the first test (measuring during sleep and create OSA's) but released the occlusions something like 6-12 seconds after arousal. BP went up like 8-28 mm Hg.


Thus they discovered that the BP rise associated with OSA is mostly due to arousal.


Anyway, I found it interesting but would like to know more about how long it takes for OSA-triggered increases in BP to go down. Like, if I sleep without CPAP one night and my BP goes up by 20 mm Hg after I - a lanky righty, as it happens - spend a couple hours trying to inhale my big fat tongue, how long will it take for my BP to go down to baseline? A day? A week?



I've read multiple studies where BP was measured with the patient asleep (either in lab or at home with an ambulatory BP monitor) so I guess some of us can sleep through the familiar arm squeeze!



Anyway thanks for all your input, knowledge, time, and work. :)


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diamaunt
Unread post  Post subject: Re: Question for TheLankyLefty about blood pressure!  |  Posted: Thu Jan 19, 2017 10:02 pm
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TheLankyLefty wrote:
I haven't measured this. It would certainly wake the patient if their arm were being squeezed during sleep.


you might be surprised... I'm coming out of a stint in the hospital, on full monitor, (bp, heart, oximeter) and I slept through the squeezings, even though I'm a really light sleeper.

ok, admittedly, they were using a wrist cuff because of where the IVs were, and that did help, because those don't squeeze as hard.

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diamaunt
Unread post  Post subject: Re: Question for TheLankyLefty about blood pressure!  |  Posted: Thu Jan 19, 2017 10:04 pm
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chris_w wrote:
BP went up by 15-25 mm Hg.


this is why having to pee during the night is a frequent side effect of sleep apnea... increased BP causes the kidneys to produce more urine in an attempt to reduce the BP, and then, full bladder.

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TheLankyLefty
Unread post  Post subject: Re: Question for TheLankyLefty about blood pressure!  |  Posted: Fri Jan 20, 2017 9:52 am
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diamaunt wrote:
you might be surprised... I'm coming out of a stint in the hospital, on full monitor, (bp, heart, oximeter) and I slept through the squeezings, even though I'm a really light sleeper.

ok, admittedly, they were using a wrist cuff because of where the IVs were, and that did help, because those don't squeeze as hard.
I heard you were in the hospital and was wishing you well. Must've worked! ;) I just got out of the hospital too....seriously. I had the forearm cuff going off every two hours along with blood draws. I look like a heroin junkie.

A wrist cuff would be better for sure.
Glad that you're out of the hospital and I hope that you're feeling better! :)

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diamaunt
Unread post  Post subject: Re: Question for TheLankyLefty about blood pressure!  |  Posted: Fri Jan 20, 2017 12:13 pm
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TheLankyLefty wrote:
I heard you were in the hospital

wow, the grapevine must be in full swing :shock:

TheLankyLefty wrote:
and was wishing you well. Must've worked! ;)

must have ;)

TheLankyLefty wrote:
I just got out of the hospital too....seriously. I had the forearm cuff going off every two hours along with blood draws. I look like a heroin junkie.
mine was every hour, I think, except during dialysis, where it was ever 15 minutes. gotta love those 3am vampire visits... *lol*

now, it's just waiting for the bruises to heal :lol:

TheLankyLefty wrote:
A wrist cuff would be better for sure.
Glad that you're out of the hospital and I hope that you're feeling better! :)

yeah, me too.. I'm glad you're better too!

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