A 73-year-old man has daytime sleepiness and hypertension. What effect will continuous positive airway pressure treatment have?

• A. Decrease in pulse rate
• B. Increase in serum creatinine concentration
• C. Decrease in serum glucose concentration
• D. Decrease in blood pressure

Answer: (D)

Continuous positive airway pressure (CPAP) treatment is primarily used in managing obstructive sleep apnea (OSA), a condition that can cause daytime sleepiness, and is often associated with other comorbidities like hypertension. The use of CPAP helps to maintain an open airway during sleep, which leads to better oxygenation and reduction in apnea episodes.

One of the significant benefits of CPAP therapy in patients with OSA is its impact on blood pressure. Studies have shown that effective treatment of OSA with CPAP can lead to a decrease in blood pressure. This happens because relieving the intermittent hypoxia and the resulting sympathetic nervous system activation that occurs during apneic episodes helps to reduce overall vascular resistance and improves cardiovascular function. Consequently, this can lead to lower daytime and nighttime blood pressure readings for patients who suffer from elevated blood pressure due to OSA.

Thus, the correct choice that reflects a substantial and documented effect of CPAP treatment in this scenario is a decrease in blood pressure. The other options do not align with the expected physiological outcomes associated with CPAP therapy for a patient who presents with sleep apnea and hypertension.