TY - JOUR
T1 - Effect of acute intermittent CPAP depressurization during sleep in obese patients
AU - Jun, Jonathan C.
AU - Unnikrishnan, Dileep
AU - Schneider, Hartmut
AU - Kirkness, Jason
AU - Schwartz, Alan R.
AU - Smith, Philip L.
AU - Polotsky, Vsevolod Y.
N1 - Publisher Copyright:
© 2016 Jun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/1/5
Y1 - 2016/1/5
N2 - 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.
AB - 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.
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U2 - 10.1371/journal.pone.0146606
DO - 10.1371/journal.pone.0146606
M3 - Article
C2 - 26731735
AN - SCOPUS:84953897558
SN - 1932-6203
VL - 11
JO - PloS one
JF - PloS one
IS - 1
M1 - e0146606
ER -