Evidence map›Paper›PMID 41811641›Full record

Trial reportSleep & breathing = Schlaf & Atmung2026

Propranolol mitigates sleep apnea-related cardiac responses during CPAP withdrawal: a randomized placebo-controlled cross-over clinical study.

Luu V Pham, Daisy Duan, Varun Badami, Jamie Perin, Mariah Potocki, Vsevolod Y Polotsky, Jonathan C Jun

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03049306 (Propranolol for Sleep Apnea Therapy), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03049306 phase2completednot on this map

Propranolol for Sleep Apnea Therapy

TypeinterventionalSponsorJohns Hopkins UniversityRan2017 to 2024Enrolled24ConditionsObstructive Sleep ApneaArmsPropranolol Oral Tablet, Placebo Oral Tablet
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Luu V PhamDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, USA. lpham1@jhmi.edu.ORCID 0000-0002-1944-6315
Daisy DuanDivision of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, USA.
Varun BadamiDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, USA.
Jamie PerinDivision Global Disease Epidemiology and Control, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Mariah PotockiDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, USA.
Vsevolod Y PolotskyDepartments of Anesthesiology and Critical Care Medicine and Pharmacology and Physiology, George Washington University School of Medicine and Health Sciences, Washington D. C, USA.
Jonathan C JunDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, USA. jjun2@jhmi.edu.

Funding

Lipolysis during sleep and cardiometabolic consequences of sleep apneaR01HL135483 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI JUN, JONATHAN C. · 2018 to 2022
$4.3M
Metabolic Effects of Circadian-Based Dinner TimeK23DK133690 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI Daisy Duan · 2022 to 2026
$1.0M
Impact of Nocturnal Hypoxemia on Glucose during Sleep in High Altitude Sleep Disordered BreathingK23HL155730 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Luu Van Pham · 2022 to 2026
$981k
NHLBI NIH HHS K23 HL155730NHLBI NIH HHS K23HL155730NHLBI NIH HHS R01 HL135483NHLBI NIH HHS R01HL135483NIDDK NIH HHS K23 DK133690NIDDK NIH HHS K23DK133690
6 · The paper itself

Abstract

backgroundObstructive Sleep Apnea (OSA) causes hemodynamic and autonomic changes during sleep that may promote cardiovascular dysfunction. The extent of heart rate acceleration following respiratory events is associated with mortality in OSA patients. Beta blockers may blunt hemodynamic sequelae of OSA but their impact on heart rate, breathing, sleep and vascular function have not been systematically studied.

methodsWe performed a double-blind randomized crossover study of long-acting propranolol long-acting (LA, 80 mg) vs. placebo interceded by a 1-week washout in OSA patients. In these patients, we used a 3-night CPAP withdrawal protocol to temporarily elicit severe untreated OSA. Participants received propranolol or placebo at 6:30 PM and underwent polysomnography followed by morning blood pressure (BP), reactive hyperemia index (RHI) and augmentation index (AIX) assessments. The primary outcome was heart rate. Secondary outcomes heart rate trajectory over time, OSA severity, sleep architecture, BP, RHI and AIX. Outcomes were compared non-parametric paired tests, or mixed effects regression for heart rate trajectory.

results21 participants (51 ± 11 years old, 62% male, BMI 33.8 ± 6.8 kg/m2) completed the study. Propranolol decreased mean overnight heart rate by 3.6 BPM (p < 0.001). Analysis by event phase revealed that propranolol reduced heart rate during stable sleep and blunted heart rate accelerations associated with apneas, hypopneas and arousals. Propranolol also reduced sleep efficiency, stage N2 sleep percentage and morning diastolic BP was reduced by propranolol but OSA severity, systolic BP, RHI or AIX were unchanged.

conclusionPropranolol mitigates markers of OSA-related cardiovascular risk including disordered-breathing-related heart rate accelerations but impaired sleep quality. These findings may have therapeutic application for patients with OSA and inform the interpretation of data from patients with OSA taking BB. Clinical Trial Registration. NCT03049306.

Indexed as

Adrenergic beta-AntagonistsContinuous Positive Airway PressureHeart RatePropranololSleep Apnea, ObstructiveAdultBlood PressureCross-Over StudiesDouble-Blind MethodFemaleHumansMaleMiddle AgedPolysomnographyAdrenergic beta-AntagonistsPropranololBeta blockerHeart ratePropranololSleep apnea

Identifiers

PMID41811641
PMCPMC12979265

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.