Eligibility Details:
Inclusion Criteria:
- Age between 18 and 75 years
- Apnea-Hypopnea Index (AHI) ≥ 15 events/hr on diagnostic polysomnography(PSG)
- No previous history of surgical treatment of OSA, and no medical treatment of OSA
within the past 6 months
- Adherence to prescribed anti-hypertensive medications as assessed by an average
adherence between Visits 1-2 of at least 0.85
- Arm circumference less than 50 cm
Exclusion Criteria:
- Unable or unwilling to provide informed consent
- No telephone access or inability to return for follow-up
- Diagnosis of another sleep disorder in addition to OSA (e.g., periodic limb movement
disorder [greater than 5 limb movements associated with arousal/hr of sleep], central
sleep apnea [greater than 50% of apneas are central apneas], obesity hypoventilation
syndrome, narcolepsy)
- Positive urine drug screen for any of the following: amphetamines, cocaine, opiates,
barbiturates, benzodiazepines, phencyclidine (PCP), tetrahydrocannabinol (THC),
alcohol (ETOH), methadone (Visit 1)
- Requiring oxygen, bi-level positive airway pressure, or adaptive servo-ventilation for
treatment of OSA
- Oxygen saturation < 87% for a period of 2 minutes during resting wakefulness during
home sleep testing (HST) or PSG (Visit 2)
- Severe and inadequately controlled arterial hypertension (SBP greater than 180 mm Hg;
diastolic BP greater than 110 mm Hg on 2 of 3 spot measurements on Visit 1)
- Participants with 24-hr SBP ≥ 140 mm Hg who are not on BP medications and participants
on 4 or more BP medications with a 24-hr SBP < 135 mm Hg (Visit 2)
- A clinically unstable medical condition as defined by a change in medications in the
previous month, including anti-hypertensive medications, or a new medical diagnosis in
the previous 2 months (e.g., myocardial infarction, chronic heart failure, unstable
angina, active infection, thyroid disease, depression or psychosis, cirrhosis,
surgery, or cancer)
- Shift workers, individuals who regularly experience jet lag, or have irregular work
schedules by history over the last 3 months
- Women who are pregnant or sexually active and of child-bearing age not using a form of
contraceptive
- Routine consumption of > 2 alcoholic beverages/day Excessive use of caffeine (greater
than 10 cups/day)
- Inability to communicate verbally or less than a 5th grade reading level