PAP therapy during split-night studies produces immediate hemodynamic stabilization, reflected by a large and significant reduction in nocturnal BP variability in both hypertensive and non-hypertensive patients.
PAP therapy produced a significant and large reduction in nocturnal blood pressure fluctuation in hypertensive individuals during split-night polysomnography.
PAP therapy produced a significant and large reduction in nocturnal blood pressure fluctuation in non-hypertensive individuals during split-night polysomnography.
The reduction in nocturnal blood pressure fluctuation after PAP therapy did not differ significantly between hypertensive and non-hypertensive individuals after adjustment for covariates.
The study used pulse transit time (PTT)-derived nocturnal blood pressure fluctuation as its primary hemodynamic measure, validated using manufacturer algorithms.
The retrospective cohort study included 464 adults undergoing split-night polysomnography over an eight-year period.
This research suggests that starting positive airway pressure (PAP) therapy — commonly used to treat sleep apnea — rapidly stabilizes blood pressure swings that occur during sleep. The study tracked nighttime blood pressure fluctuations in 464 adults using a sensor-based method called pulse transit time, which estimates blood pressure changes without a traditional cuff. During a 'split-night' sleep study, patients first slept without treatment and then with PAP therapy in the same night, allowing researchers to compare blood pressure variability before and after therapy began. Both groups showed large reductions in nocturnal blood pressure swings after PAP was started, with average reductions of about 19–21 mmHg in variability. Importantly, this stabilizing effect occurred equally in people who already had high blood pressure (hypertension) and those who did not. After adjusting for age and starting blood pressure variability, there was no meaningful difference between the two groups in how much PAP therapy helped. This suggests the cardiovascular benefit of PAP therapy during sleep is not limited to people already diagnosed with hypertension. This research suggests that initiating PAP therapy early — even in individuals not yet diagnosed with hypertension — may help reduce harmful nighttime blood pressure swings associated with sleep-disordered breathing. Erratic blood pressure during sleep has been linked to cardiovascular risks, so these findings point to a potential benefit of prompt PAP treatment for a broader population of sleep apnea patients.
Vaidya D, Joshi A, Johnson S. (2026). Immediate hemodynamic stabilization with positive airway pressure: PTT-derived nocturnal blood pressure fluctuations during split-night polysomnography.. Sleep & breathing = Schlaf & Atmung. https://doi.org/10.1007/s11325-026-03812-x