Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients.
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 o...
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doaj-7fe418d916214090a0e211189878c2f82020-11-24T20:49:55ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01111e014660610.1371/journal.pone.0146606Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients.Jonathan C JunDileep UnnikrishnanHartmut SchneiderJason KirknessAlan R SchwartzPhilip L SmithVsevolod Y PolotskyObstructive 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.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 H20) 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.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).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.http://europepmc.org/articles/PMC4701426?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jonathan C Jun Dileep Unnikrishnan Hartmut Schneider Jason Kirkness Alan R Schwartz Philip L Smith Vsevolod Y Polotsky |
spellingShingle |
Jonathan C Jun Dileep Unnikrishnan Hartmut Schneider Jason Kirkness Alan R Schwartz Philip L Smith Vsevolod Y Polotsky Effect of Acute Intermittent CPAP Depressurization during Sleep in Obese Patients. PLoS ONE |
author_facet |
Jonathan C Jun Dileep Unnikrishnan Hartmut Schneider Jason Kirkness Alan R Schwartz Philip L Smith Vsevolod Y Polotsky |
author_sort |
Jonathan C Jun |
title |
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_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_sort |
effect of acute intermittent cpap depressurization during sleep in obese patients. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2016-01-01 |
description |
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.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 H20) 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.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).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. |
url |
http://europepmc.org/articles/PMC4701426?pdf=render |
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