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SLEEP MEDICINE: Lucia Spicuzza, Luciano Bernardi, Rossella Balsamo, Nicola Ciancio, Riccardo Polosa, and Giuseppe Di Maria Effect of Treatment With Nasal Continuous Positive Airway Pressure on Ventilatory Response to Hypoxia and Hypercapnia in Patients With Sleep Apnea Syndrome Chest 2006; 130: 774-779 [Abstract] [Full text] [PDF]

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Rosa D Grembiale, Francesco Perticone   (16 March 2007)

Untitled 16 March 2007
Rosa D Grembiale Clinica and Experimental Medicine, University of Catanzaro, Francesco Perticone Send letter to journal: Re: this article rdgrembiale{at}unicz.it Rosa D Grembiale, et al.	We read with great interest your article “Effect of treatment with nasal continuous positive airway pressure on ventilatory response to hypoxia and hypercapnia in patients with sleep apnea syndrome” published in Sep 2006, and we have some note to the authors. First: between exclusion criteria were hypertension and smoke. But all patients were invited to not smoking two hours before rebreathing test. The question is: in this study was smoking or not smoking patients included? Second: in table 1, patients treated with nCPAP and sham nCPAP had systolic blood pressure (SBP) levels 145,4±4,7 and 149,5±7,2 respectively; levels higher by comparison with normal, therefore all patients, according with WHO guideline had Grade 1 Hypertension (1). Third: BMI was 31.1±4.2 in therapeutic nCPAP and 33.5±5,5 in sham nCPAP respectively. Therefore all patients were overweigth or obese. Obesity is a major risk factor for OSAS as well as for other diseases including hypertension and cardiovascular disease (2) (3). Reduction of excessive weight is an important therapeutic goal independent of its beneficial effects on OSAS, so before undertaking a treatment with nasal cPAP, modifying in sense negative the quality of life, we think is necessary to invite the subjects to have a persistent weight reduction the only main therapeutic action to reduce fatal and nonfatal cardiovascular events. Best regards Rosa Daniela Grembiale Francesco Perticone 1. WORLD HEALTH ORGANIZATION-INTERNATIONAL SOCIETY OF HYPERTENSION GUIDELINES FOR THE MANAGEMENT OF HYPERTENSION , J. Hypertens. 17: 151, 1999 2. Young T, Peppard PE, Taheri S. Excess weight and sleep-disordered breathing. J Appl Physiol 2005;99:1592–9. 3. Sciacqua A, Candigliota M, Ceravolo R, Scozzafava A, Sinopoli F, Corsonello A, Sesti G, Perticone F: Weight loss in combination with physical activity improves endothelial dysfunction in human obesity. Diabetes Care. 2003 Jun;26(6):1673-8.