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Sleep-linked Effects on Enhancing Blood Pressure Reduction:
A Systematic Review and Meta-analysis
Oranut Chatsirisakul1, Natasha Leenabanchong2, Chanchira Sirivasuvat3, Nich Paibulsirijit4, Chi Hang Pang5
,
Natchanon Rungbanapan6, Krit Pongpirul7*
1 Faculty of Medicine, Chulalongkorn University
2 Princess Srisavangavadhana College of Medicine Chulabhorn Royal Academy
3 Chulalongkorn University International Medical Program (CU-MEDi), Faculty of Medicine, Chulalongkorn
University
4 Division of Hospital and Ambulatory Medicine, Department of Medicine, Faculty of Medicine,
Chulalongkorn University
5 Faculty of Medicine, The Chinese University of Hong Kong
6 Faculty of Medicine, University of St Andrews
7 Center of Excellence in Preventive and Integrative Medicine (CE-PIM), Faculty of Medicine, Chulalongkorn
University
*Corresponding Author E-mail: doctorkrit@gmail.com
Background: Methods: Abstract
Continuous positive airway pressure (CPAP) and therapeutic sleep studies, such as titration
and split-night polysomnography, are fundamental treatments for obstructive sleep apnea
(OSA). Emerging evidence suggests these interventions may significantly lower blood
pressure, potentially matching or surpassing the efficacy of antihypertensive medications,
particularly in patients with resistant hypertension or poor medication adherence.
However, their blood pressure-lowering impact across different baseline systolic blood
pressure (SBP) categories remains unclear. This systematic review and meta-analysis
aimed to quantify the effect of therapeutic sleep interventions on SBP reduction according
to baseline SBP subgroups.
We systematically searched PubMed, Embase, CENTRAL, and Scopus for randomized
controlled trials (RCTs) evaluating therapeutic sleep studies with reported pre- and post-
intervention SBP. Random-effects meta-analyses were conducted using Review Manager
(RevMan) 5.4 across five baseline SBP categories: <120, 120–125, 125–130, 130–135,
and >135 mmHg. Heterogeneity was evaluated using I² statistics. Influence analysis and
meta-regression were performed to identify potential effect modifiers. Two reviewers
independently assessed the risk of bias using the Cochrane Risk of Bias 2.0 tool.
118 Joint Conference in Medical Sciences 2025