Studying Continuous Positive Airway Pressure CPAP to Lower Nighttime High Blood Pressure in Adults with Autonomic Failure and Neurogenic Orthostatic Hypotension

What this Trial Is About

Researchers are studying the effects of continuous positive airway pressure CPAP on people aged 40 to 80 with autonomic failure and high blood pressure while lying down, known as supine hypertension. The goal is to see if CPAP, commonly used for sleep apnea, can treat high nighttime blood pressure in this group. The study is conducted at Vanderbilt University Medical Center and involves evaluating blood pressure and heart function under different conditions. The study includes up to 5 days at the research center, starting with screening tests like physical exams, lab tests, and autonomic nervous system evaluations. Participants may join daytime andor overnight study phases. During the daytime study, they undergo two sessions with active CPAP or sham CPAP applied while awake for up to 2 hours. The overnight study involves three nights with active CPAP, sham CPAP, or sleeping with the bed tilted head-up, each for up to 9 hours. Active CPAP pressure levels are set during a prior titration trial. Participants will have blood pressure, heart rate, and other cardiovascular measures monitored during the interventions. Blood and urine samples will be collected, and a tilt table test will be done the morning after overnight studies. Researchers will assess changes in systolic blood pressure during the day and night, stroke volume, hormone levels, urine output, and orthostatic tolerance. The entire process includes careful monitoring and safety assessments, with study participation lasting up to 5 days.

CPAP for the Treatment of Supine Hypertension