Study objective. To investigate 6-month effects of CPAP therapy with auto-adaptation to inhalation and exhalation of obstructive sleep apnea (OSA) patient with MS (A-Flex therapy) on carbohydrate metabolism, lipid metabolism and blood pressure (BP). Materials and methods. To the prospective single-center study were included 30 (19 male [63,3%] и 11 female [36,7%], 51,70±11,54 year) OSA patients with MS and apnea-hypopnea index (AHI) >15 events/hour. The night polygraphy study (PG) was performed to calculate AHI, oxygen desaturation index (ODI), mean nocturnal saturation (Sp02 mean) by the rules of American academy of sleep medicine. Endothelial function of blood vessels determined by finger test was measured according to peripheral arterial tone (PAT). The reactive hyperemia index (RHI) and augmentation index (AI) was calculated. Optimal level of A-Flex therapy was adjusted at home. AHI, the level of air leakage, average pressure and compliance to CPAP treatment were established in accordance with international requirements. Results. After 6 months of A-Flex therapy we found a significant decrease of level of systolic and diastolic blood pressure (p=0,004), normalization of the level of glycated hemoglobin (HbA1С) (p=0,03), normalization index of reactive hyperemia (RHI) (p=0.004), normalization of the augmentation index (AI) (p=0.003). There was statistically significant moderate strength (r=0.53; p<0.01) correlation between severity of sleep apnea (AHI) and level of vessel endothelium damage (RHI). There was a modest correlation (r=0,49; p<0.01) between severity of oxygen desaturations (ODI) and level of arterial stiffness (AI), associated with increased level of central BP and post load of the myocardium of the left ventricle. Conclusions. 6-month A-Flex therapy in OSA patients with MS has a significant therapeutic effect of stabilization systolic and diastolic blood pressure, level of blood lipids and glycated hemoglobin, level of endothelial dysfunction. The 6-month A-Flex therapy has to able to reduce the risks of cardiovascular events in moderate and severe OSA patients with acute metabolic manifestations.

Keywords: A-Flex therapy, CPAP therapy, obstructive sleep apnea, metabolic syndrome, cardiovascular disease