Effect of acute intermittent CPAP depressurization during sleep in obese patients

Jonathan Jun, Dileep Unnikrishnan, Hartmut Schneider, Jason Kirkness, Alan R Schwartz, Philip L Smith, Vsevolod Polotsky

Research output: Contribution to journalArticle

Abstract

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 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. 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 (p0.05). The average 3% ODI during CPAP-on and CPAP-off was 4.7 2 and 20.4 4.7 respectively (p0.05). CPAP depressurization also induced more awake (p0.05) and stage N1 (p0.01) sleep, and less stage REM (p0.05) 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.

Original languageEnglish (US)
Article numbere0146606
JournalPLoS One
Volume11
Issue number1
DOIs
StatePublished - Jan 5 2016

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Continuous Positive Airway Pressure
sleep
Sleep
sleep apnea
Obstructive Sleep Apnea
Atmospheric Pressure
Sleep Stages
atmospheric pressure

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Effect of acute intermittent CPAP depressurization during sleep in obese patients. / Jun, Jonathan; Unnikrishnan, Dileep; Schneider, Hartmut; Kirkness, Jason; Schwartz, Alan R; Smith, Philip L; Polotsky, Vsevolod.

In: PLoS One, Vol. 11, No. 1, e0146606, 05.01.2016.

Research output: Contribution to journalArticle

Jun, Jonathan ; Unnikrishnan, Dileep ; Schneider, Hartmut ; Kirkness, Jason ; Schwartz, Alan R ; Smith, Philip L ; Polotsky, Vsevolod. / Effect of acute intermittent CPAP depressurization during sleep in obese patients. In: PLoS One. 2016 ; Vol. 11, No. 1.
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