Tuesday, August 16, 2011

CPAP therapy withdrawal in OSA patients may bring back the OSA (obstructive sleep apnea)

The Study :
The effects of CPAP therapy withdrawal in patients with obstructive sleep apnea: a randomised controlled trial
Rationale:
To establish a new approach to investigate the physiological effects of OSA, and evaluate novel treatments, during a period of CPAP-withdrawal.
Objectives: To determine the effects of CPAP-withdrawal Measurements and main results:

41 OSA patients on CPAP were randomized to either CPAP-withdrawal (subtherapeutic-CPAP), or continue CPAP, for two weeks. Polysomnography, sleepiness, psychomotor performance, endothelial function, blood pressure (BP), heart rate (HR), urinary catecholamines, blood markers of systemic inflammation and metabolism were assessed. CPAP-withdrawal lead to a recurrence of OSA within a few days and a return of subjective sleepiness, but was not associated with significant deterioration of psychomotor performance within two weeks.

FRIDAY, Aug. 12 (HealthDay News) -- Obstructive sleep apnea (OSA) and sleepiness rapidly return when patients stop using continuous positive airway pressure (CPAP) machines, a new study finds.

CPAP is a common treatment for OSA patients, whose breathing is interrupted many times during sleep due to the repeated blockage of the upper airway. CPAP keeps the airway open by pumping a continuous stream of air through a mask or nose piece the patient wears while sleeping.

This Swiss study included patients on CPAP therapy who were randomly selected to either continue or discontinue CPAP for two weeks. Those who stopped CPAP experienced a return of OSA and sleepiness within a few days. Within 14 days, they had significant increases in heart rate and blood pressure, and a deterioration in vascular function.

The results suggest that even a short break in CPAP therapy has a negative effect on the cardiovascular system, the researchers said.

They also noted their findings show that OSA patients need to continuously use CPAP, including taking their machines with them on holidays.

The study appears online in the American Journal of Respiratory and Critical Care Medicine.

SOURCE: American Journal of Respiratory and Critical Care Medicine, Via MedlinePlus

Sleep apnea is a common disorder that can be serious. In sleep apnea, your breathing stops or gets very shallow. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour.

The most common type is obstructive sleep apnea. That means you are unable to get enough air through your mouth and nose into your lungs. When that happens, the amount of oxygen in your blood may drop. Normal breaths resume with a snort or choking sound. People with sleep apnea often snore loudly. However, not everyone who snores has sleep apnea.

When your sleep is interrupted throughout the night, you can be drowsy during the day. People with sleep apnea are at higher risk for car crashes, work-related accidents and other medical problems. If you have it, it is important to get treatment.

NIH: National Heart, Lung, and Blood Institute

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