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Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients

BACKGROUND: Obstructive Sleep Apnea (OSA) describes intermittent collapse of the airway during sleep, for which continuous positive airway pressure (CPAP) is often prescribed for treatment. Prior studies suggest that discontinuation of CPAP leads to a gradual, rather than immediate return of baselin...

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Autores principales: Jun, Jonathan C., Unnikrishnan, Dileep, Schneider, Hartmut, Kirkness, Jason, Schwartz, Alan R., Smith, Philip L., Polotsky, Vsevolod Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701426/
https://www.ncbi.nlm.nih.gov/pubmed/26731735
http://dx.doi.org/10.1371/journal.pone.0146606
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author Jun, Jonathan C.
Unnikrishnan, Dileep
Schneider, Hartmut
Kirkness, Jason
Schwartz, Alan R.
Smith, Philip L.
Polotsky, Vsevolod Y.
author_facet Jun, Jonathan C.
Unnikrishnan, Dileep
Schneider, Hartmut
Kirkness, Jason
Schwartz, Alan R.
Smith, Philip L.
Polotsky, Vsevolod Y.
author_sort Jun, Jonathan C.
collection PubMed
description BACKGROUND: Obstructive Sleep Apnea (OSA) describes intermittent collapse of the airway during sleep, for which continuous positive airway pressure (CPAP) is often prescribed for treatment. Prior studies suggest that discontinuation of CPAP leads to a gradual, rather than immediate return of baseline severity of OSA. The objective of this study was to determine the extent of OSA recurrence during short intervals of CPAP depressurization during sleep. METHODS: Nine obese (BMI = 40.4 ± 3.5) subjects with severe OSA (AHI = 88.9 ± 6.8) adherent to CPAP were studied during one night in the sleep laboratory. Nasal CPAP was delivered at therapeutic (11.1 ± 0.6 cm H(2)0) or atmospheric pressure, in alternating fashion for 1-hour periods during the night. We compared sleep architecture and metrics of OSA during CPAP-on and CPAP-off periods. RESULTS: 8/9 subjects tolerated CPAP withdrawal. The average AHI during CPAP-on and CPAP-off periods was 3.6 ± 0.6 and 15.8 ± 3.6 respectively (p<0.05). The average 3% ODI during CPAP-on and CPAP-off was 4.7 ± 2 and 20.4 ± 4.7 respectively (p<0.05). CPAP depressurization also induced more awake (p<0.05) and stage N1 (p<0.01) sleep, and less stage REM (p<0.05) with a trend towards decreased stage N3 (p = 0.064). CONCLUSION: Acute intermittent depressurization of CPAP during sleep led to deterioration of sleep architecture but only partial re-emergence of OSA. These observations suggest carryover effects of CPAP.
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spelling pubmed-47014262016-01-15 Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients Jun, Jonathan C. Unnikrishnan, Dileep Schneider, Hartmut Kirkness, Jason Schwartz, Alan R. Smith, Philip L. Polotsky, Vsevolod Y. PLoS One Research Article BACKGROUND: Obstructive Sleep Apnea (OSA) describes intermittent collapse of the airway during sleep, for which continuous positive airway pressure (CPAP) is often prescribed for treatment. Prior studies suggest that discontinuation of CPAP leads to a gradual, rather than immediate return of baseline severity of OSA. The objective of this study was to determine the extent of OSA recurrence during short intervals of CPAP depressurization during sleep. METHODS: Nine obese (BMI = 40.4 ± 3.5) subjects with severe OSA (AHI = 88.9 ± 6.8) adherent to CPAP were studied during one night in the sleep laboratory. Nasal CPAP was delivered at therapeutic (11.1 ± 0.6 cm H(2)0) or atmospheric pressure, in alternating fashion for 1-hour periods during the night. We compared sleep architecture and metrics of OSA during CPAP-on and CPAP-off periods. RESULTS: 8/9 subjects tolerated CPAP withdrawal. The average AHI during CPAP-on and CPAP-off periods was 3.6 ± 0.6 and 15.8 ± 3.6 respectively (p<0.05). The average 3% ODI during CPAP-on and CPAP-off was 4.7 ± 2 and 20.4 ± 4.7 respectively (p<0.05). CPAP depressurization also induced more awake (p<0.05) and stage N1 (p<0.01) sleep, and less stage REM (p<0.05) with a trend towards decreased stage N3 (p = 0.064). CONCLUSION: Acute intermittent depressurization of CPAP during sleep led to deterioration of sleep architecture but only partial re-emergence of OSA. These observations suggest carryover effects of CPAP. Public Library of Science 2016-01-05 /pmc/articles/PMC4701426/ /pubmed/26731735 http://dx.doi.org/10.1371/journal.pone.0146606 Text en © 2016 Jun et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
spellingShingle Research Article
Jun, Jonathan C.
Unnikrishnan, Dileep
Schneider, Hartmut
Kirkness, Jason
Schwartz, Alan R.
Smith, Philip L.
Polotsky, Vsevolod Y.
Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients
title Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients
title_full Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients
title_fullStr Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients
title_full_unstemmed Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients
title_short Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients
title_sort effect of acute intermittent cpap depressurization during sleep in obese patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701426/
https://www.ncbi.nlm.nih.gov/pubmed/26731735
http://dx.doi.org/10.1371/journal.pone.0146606
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