scholarly journals CPAP Treatment Partly Normalizes Sleep Spindle Features in Obstructive Sleep Apnea

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Tiia Saunamäki ◽  
Eero Huupponen ◽  
Juho Loponen ◽  
Sari-Leena Himanen
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Control Group ◽  
Sleep Spindles ◽  
Sleep Spindle ◽  
Cpap Treatment ◽  
Automated Method ◽  
Obstructive Sleep

Objective. Obstructive sleep apnea (OSA) decreases sleep spindle density and frequency. We evaluated the effects of continuous positive airway pressure (CPAP) treatment on different features of sleep spindles.Methods. Twenty OSA patients underwent two night polysomnographies in a diagnostic phase and one night polysomnography after 6 months of CPAP treatment. The control group comprised 20 healthy controls. Sleep spindles were analyzed by a previously developed automated method. Unilateral and bilateral spindles were identified in central and frontopolar brain locations. Spindle density and frequency were determined for the first and last half of the NREM time.Results. The density of bilateral central spindles, which did not change in the untreated OSA patients, increased towards the morning hours during CPAP treatment and in the controls. Central spindles did not become faster with sleep in OSA patients and the central spindles remained slow in the left hemisphere even with CPAP.Conclusion. CPAP treatment normalized spindle features only partially. The changes may be associated with deficits in thalamocortical spindle generating loops.Significance. This study shows that some sleep spindle changes persist after CPAP treatment in OSA patients. The association of these changes to daytime symptoms in OSA patients needs to be further evaluated.

scholarly journals Cost-Effectiveness Analysis of Positive Airway Pressure in Patient with Obstructive Sleep Apnea

2021 ◽  
Vol 28 (2) ◽  
pp. 94-101
Author(s):  
Hansol Kim ◽  
Jin Kook Kim ◽  
Jae Hoon Cho
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cost Effectiveness ◽  
Sleep Apnea ◽  
Treatment Group ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Control Group ◽  
Medical Expenses ◽  
Effectiveness Analysis ◽  
Obstructive Sleep

Background and Objectives: Positive airway pressure (PAP) is effective at reducing the number of complications in patients with obstructive sleep apnea (OSA). To the best of our knowledge, no cost-effectiveness analysis of PAP has been conducted in Korea. Subjects and Method: We classified subjects into two groups, those with moderate-to-severe OSA who used PAP after polysomnography (PAP treatment group) and those who did not receive a diagnosis and treatment (control group), and compared their medical expenses over a period of 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicular accidents, and work-related accidents) with or without PAP was adopted through a literature review. The average medical expenses for treating each complication and accident were found by searching several databases. The analysis consisted of a payer’s perspective and a societal perspective. Results: The incidence of all complications was higher in the control group than in the PAP treatment group. However, since the absolute incidence rate was not high in either group and medical expenses in Korea are low, the expected treatment cost was not high. In contrast, the PAP rental fee was relatively high. To obtain 1 unit of disability-adjusted life year, it costs 40,873,288 won from the payer’s perspective and 31,791,810 won from the societal perspective. Conclusion: PAP treatment reduces patient complications and extends their lifespan, but costs must be considered.

Relationship between obstructive sleep apnea and endogenous carbon monoxide

2017 ◽  
Vol 122 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Masanori Azuma ◽  
Kimihiko Murase ◽  
Ryo Tachikawa ◽  
Satoshi Hamada ◽  
Takeshi Matsumoto ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carbon Monoxide ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Surrogate Marker ◽  
Control Group ◽  
Cpap Therapy ◽  
Obstructive Sleep

Endogenous carbon monoxide (CO) levels are recognized as a surrogate marker for activity of heme oxygenase-1, which is induced by various factors, including hypoxia and oxidative stress. Few reports have evaluated endogenous CO in patients with obstructive sleep apnea (OSA). Whether OSA more greatly affects exhaled or blood CO is not known. Sixty-nine patients with suspected OSA were prospectively included in this study. Exhaled and blood CO were evaluated at night and morning. Blood and exhaled CO levels were well correlated both at night and morning ( r = 0.52, P < 0.0001 and r = 0.61, P < 0.0001, respectively). Although exhaled CO levels both at night and morning significantly correlated with total sleep time with arterial oxygen saturation < 90% (ρ = 0.41, P = 0.0005 and ρ = 0.27, P = 0.024, respectively), blood CO levels did not correlate with any sleep parameter. Seventeen patients with an apnea and hypopnea index (AHI) < 15 (control group) were compared with 52 patients with AHI ≥ 15 (OSA group). Exhaled CO levels at night in the OSA group were significantly higher than in the control group (3.64 ± 1.2 vs. 2.99 ± 0.70 ppm, P < 0.05). Exhaled CO levels at night decreased after 3 mo of continuous positive airway pressure (CPAP) therapy in OSA patients ( n = 36; P = 0.016) to become nearly the same level as in the control group ( P = 0.21). Blood CO levels did not significantly change after CPAP therapy. Exhaled CO was positively related to hypoxia during sleep in OSA patients, but blood CO was not. Exhaled CO might better correlate with oxidative stress associated with OSA than blood CO. NEW & NOTEWORTHY Endogenous carbon monoxide (CO) levels are recognized to be a surrogate marker of oxidative stress. No study has evaluated both exhaled and blood CO at the same time in obstructive sleep apnea (OSA) patients. Here we provide evidence that exhaled CO levels positively correlated with hypoxia during sleep in OSA patients, but blood CO levels did not, and that continuous positive airway pressure therapy significantly decreased exhaled CO levels in the OSA group, but did not significantly affect blood CO.

scholarly journals Do Obstructive Sleep Apnea Syndrome Patients Underestimate Their Daytime Symptoms before Continuous Positive Airway Pressure Treatment?

2014 ◽  
Vol 21 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Gabrielle Leclerc ◽  
Yves Lacasse ◽  
Diane Page ◽  
Frédéric Sériès
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Before And After ◽  
Pretreatment Score

BACKGROUND: Daytime somnolence is an important feature of the obstructive sleep apnea (OSA) hypopnea syndrome and is usually subjectively assessed using the Epworth Sleepiness Scale (ESS).OBJECTIVE: To compare the scores of the ESS and different domains of the Quebec Sleep Questionnaire (QSQ) assessed before and after the first months of continuous positive airway pressure (CPAP) treatment, as well as retrospectively without treatment.METHODS: The ESS score and domain scores of the QSQ were obtained before and after a three-month period of CPAP treatment using a retrospective assessment of the pretreatment scores in 76 untreated OSA patients.RESULTS: Fifty-two patients completed the study. The ESS and QSQ scores significantly improved following CPAP therapy. Retrospective evaluation of the ESS score was significantly worse than pre- and post-treatment values (mean [± SD] pretreatment score 11.0±4.8; retrospective pretreatment score 13.5±5.1). Such differences were not observed in any domain of the QSQ, including the domain assessing hypersomnolence.CONCLUSION: OSA patients underestimated their sleepiness according to the most widely used instrument to assess hypersomnolence. This finding may not be observed with other methods used to assess OSA-related symptoms such as quality of life questionnaires.

scholarly journals Potential Therapeutic Effect of Continuous Positive Airway Pressure on Laryngopharyngeal Reflux in Obstructive Sleep Apnea Patients

2021 ◽  
Vol 10 (13) ◽  
pp. 2861
Author(s):  
Jae Hyuk Choi ◽  
Eunkyu Lee ◽  
Sang Duk Hong ◽  
Seung Kyu Chung ◽  
Yong Gi Jung ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Therapeutic Effect ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Laryngopharyngeal Reflux ◽  
Cpap Treatment ◽  
Postnasal Drip ◽  
Obstructive Sleep

To investigate the potential therapeutic effect of continuous positive airway pressure (CPAP) treatment on laryngopharyngeal reflux in obstructive sleep apnea (OSA) patients, we performed a retrospective analysis of data prospectively collected from patients who underwent CPAP therapy after being diagnosed with moderate to severe OSA between January 2019 and May 2020. Subjects were asked to complete the reflux symptom index (RSI) questionnaire before and after CPAP. Additionally, a laryngoscopic examination was performed to evaluate objective endoscopic findings and determine reflux finding score (RFS). A total of 46 patients were included in the analysis. Overall, significant decreases in mean RSI score (10.85 ± 6.40 vs. 8.80 ± 7.99, p < 0.001) and RFS (7.41 ± 3.32 vs. 4.65 ± 2.12, p < 0.001) were observed after CPAP treatment. Within subdomains of the RSI, throat clearing, postnasal drip, breathing difficulty, troublesome cough, and foreign body sensation were significantly improved by CPAP treatment. All subdomains of RFS, with the exception of posterior commissure hypertrophy and granuloma, showed significant differences after CPAP treatment. There were no differences between subgroups according to body mass index or severity of OSA. CPAP treatment in OSA potentially reduces laryngeal reflux symptoms and improves laryngeal examination findings.

Effects of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea in arterial stiffness: A meta-analysis

2013 ◽  
Vol 17 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Iris-Theodora Vlachantoni ◽  
Eirini Dikaiakou ◽  
Costantine N. Antonopoulos ◽  
Christodoulos Stefanadis ◽  
Styliani S. Daskalopoulou ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Arterial Stiffness ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Cpap Treatment ◽  
Obstructive Sleep

scholarly journals Does Continuous Positive Airway Pressure Therapy in Patients with Obstructive Sleep Apnea Improves Uric Acid? A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Qingshi Chen ◽  
Guofu Lin ◽  
Lida Chen ◽  
Jiefeng Huang ◽  
Yaping Huang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Uric Acid ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Study Design ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Cpap Treatment ◽  
Obstructive Sleep

Purpose. The efficacy of obstructive sleep apnea (OSA) therapy with continuous positive airway pressure (CPAP) on uric acid (UA) yielded conflicting results. This meta-analysis was performed to assess whether OSA treatment with CPAP could reduce UA levels. Methods. The Web of Science, Cochrane Library, Embase, and PubMed were searched before March 2019. Information of patients, study design, and pre- and post-CPAP treatment of UA was utilized for analysis. The overall effects were analyzed via the standardized mean difference (SMD) with a 95% confidence interval (CI). Five studies were obtained and the meta-analysis was performed using Stata 12.0 and Review Manager 5.2. Results. A total of 5 studies with 6 cohorts (2 RCT and 3 observational studies) involving 270 patients were pooled into meta-analysis. There was no change of UA levels before and after CPAP treatment in OSA patients (SMD=‐0.20, 95% CI: -0.78 to 0.37, Z=0.69, p=0.49). Subgroup analysis showed that the outcomes were not affected by age of patients, gender distribution, baseline body mass index, daily duration, duration of CPAP treatment, sample size, and study design. Conclusions. This meta-analysis revealed that CPAP treatment has no effect on UA in OSA patients. Further well-designed, large-scale randomized controlled trials are required to address this issue.

scholarly journals Ten-year adherence to continuous positive airway pressure treatment in patients with moderate-to-severe obstructive sleep apnea

2020 ◽  
Vol 24 (4) ◽  
pp. 1565-1571 ◽  
Author(s):  
Matsusato Tsuyumu ◽  
Tadao Tsurumoto ◽  
Jiro Iimura ◽  
Tsuneya Nakajima ◽  
Hiromi Kojima
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Utilization Rate ◽  
Severe Obstructive Sleep Apnea ◽  
Cox Regression Analysis ◽  
Cpap Treatment ◽  
Obstructive Sleep

Abstract Purpose This study aimed to evaluate the 10-year adherence to and identify the predictors of dropout from continuous positive airway pressure (CPAP) treatment for patients with moderate-to-severe obstructive sleep apnea (OSA). Methods We retrospectively analyzed the continuity, dropout, or other behaviors of 181 patients who initiated CPAP treatment at the Tokyo Dental College Ichikawa General Hospital from January 2003 to June 2005. Results Among a total of 181 patients, 56 (30.9%) dropped out of the treatment. Among the 125 patients who did not dropout, 54 continued CPAP treatment for > 10 years, 16 completed the treatment with OSA improvement, and 7 could not complete the treatment owing to unavoidable reasons such as death, dementia, hospitalization for serious illness, or migration to other countries. Further, 47 patients moved to another facility, whereas 1 patient purchased a CPAP device and stopped visiting our facility. Among the 56 patients who dropped out, approximately 50% of the patients dropped out within a year, and all dropped out within 76 months. Comparing demographics, OSA parameters, and CPAP parameters between the patients who did and did not drop out of the treatment, Cox regression analysis indicated that body mass index (BMI) and the first-month utilization rate were clinical variables that were independently associated with discontinuation of CPAP treatment. Conclusion The results of this study show that BMI and the first-month utilization rate of CPAP treatment are the predictors of the long-term adherence to this treatment.

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