Which class of antihypertensives can reduce the severity of obstructive sleep apnea?

Which class of antihypertensives can reduce the severity of obstructive sleep apnea?

• A. ACE inhibitors
• B. Beta-blockers
• C. Aldosterone antagonists
• D. Calcium channel blockers

Answer: (C)

Aldosterone antagonists can reduce obstructive sleep apnea severity by diminishing nocturnal rostral fluid shifts and pharyngeal edema. When a person lies down, fluid moves from the legs toward the neck and upper airway, increasing edema in the pharyngeal tissues and making the airway more prone to collapse during sleep. Blocking mineralocorticoid receptors with agents like spironolactone or eplerenone reduces overall fluid retention, which lessens this nighttime edema and the likelihood of airway collapse, thereby lowering the apnea-hypopnea index in some patients, especially those with fluid overload or heart failure. Other antihypertensives don’t have a demonstrated, consistent effect on reducing airway collapsibility or nocturnal pharyngeal edema, so they’re not known to lessen OSA severity in the same way. The key idea is that targeting fluid balance at night can translate into fewer apnea events in certain individuals.

Aldosterone antagonists can reduce obstructive sleep apnea severity by diminishing nocturnal rostral fluid shifts and pharyngeal edema. When a person lies down, fluid moves from the legs toward the neck and upper airway, increasing edema in the pharyngeal tissues and making the airway more prone to collapse during sleep. Blocking mineralocorticoid receptors with agents like spironolactone or eplerenone reduces overall fluid retention, which lessens this nighttime edema and the likelihood of airway collapse, thereby lowering the apnea-hypopnea index in some patients, especially those with fluid overload or heart failure.

Other antihypertensives don’t have a demonstrated, consistent effect on reducing airway collapsibility or nocturnal pharyngeal edema, so they’re not known to lessen OSA severity in the same way. The key idea is that targeting fluid balance at night can translate into fewer apnea events in certain individuals.