Introduction: Obstructive Sleep Apnoea (OSA) constitutes the most prevalent form of abnormal
respiratory control during sleep in adults. Evidence linked OSA to cardiovascular disease, and
the role of OSA in abnormal Blood Pressure (BP) control has been extensively studied. Although longitudinal
trials suggest a causative role of OSA in the development of hypertension, the evidence is not
fully consistent. Nasal continuous positive airway pressure (nCPAP) applied during sleep is well documented
and a highly efficient therapeutic aid to eliminate OSA. It has been repeatedly shown that
nCPAP-therapy is also associated with modest BP lowering effect in hypertensive OSA-patients, and
the magnitude of the observed effect correlates with the severity of OSA. However, it is unlikely that
nCPAP would normalize BP.
Conclusion: There are few studies which tested the interplay between OSA, nCPAP and certain BPlowering
drug classes. Angiotensin receptor blockers may show synergistic hypotensive effect with
nCPAP, whereas mineralocorticoid receptor blocker has been shown to modestly attenuate the severity
of OSA. Additionally, the application of chronotherapy may be of special use in such patients. The current
evidence is sufficient to promote persistent and effective nCPAP-therapy as a standard in all eligible
OSA-patients with difficult-to-control hypertension.