Residual effect of nCPAP applied for part of the night in patients with obstructive sleep apnoea

The aim of the present study was to assess whether nasal continuous positive airway pressure (nCPAP) treatment, applied for only a few hours at the beginning of the night, has any residual effect on sleep and breathing during the ensuing hours of unassisted sleep in patients with obstructive sleep apnoea syndrome (OSAS). In 27 patients with newly-diagnosed OSAS, effective nCPAP was applied during the first part of the night and then withdrawn. Polysomnographic parameters after nCPAP withdrawal were compared with those of the corresponding part of the diagnostic polysomnography performed a few days or weeks before and with those of the first part of night on nCPAP. After 255+/-63 (mean+/-SD) min of sleep with normalization of sleep and breathing parameters under nCPAP, there was partial improvement of OSAS severity during the remaining 124+/-56 min of nocturnal sleep without treatment; mean oxygen saturation, desaturation index (equivalent to the apnoea/hypopnoea index) and movement arousal index all improved significantly with respect to the diagnostic night (p=0.001). This improvement was not accounted for by a change in sleep architecture. We conclude that there is an improvement in severity of obstructive sleep apnoea syndrome after only 4 h of nasal continuous positive airway pressure. This carryover effect could explain why a number of patients with obstructive sleep apnoea syndrome apply nasal continuous positive airway pressure for only part of the night or not every night.

This article has been cited by other articles:

				R. Chandrashekariah, Z. Shaman, and D. Auckley Impact of Upper Airway Surgery on CPAP Compliance in Difficult-to-Manage Obstructive Sleep Apnea Arch Otolaryngol Head Neck Surg, September 1, 2008; 134(9): 926 - 930. [Abstract] [Full Text] [PDF]

				D. Hwang, N. Shakir, B. Limann, C. Sison, S. Kalra, L. Shulman, A. d. C. Souza, and H. Greenberg Association of Sleep-Disordered Breathing With Postoperative Complications Chest, May 1, 2008; 133(5): 1128 - 1134. [Abstract] [Full Text] [PDF]

				D. A. Bradshaw, G. A. Ruff, and D. P. Murphy An oral hypnotic medication does not improve continuous positive airway pressure compliance in men with obstructive sleep apnea. Chest, November 1, 2006; 130(5): 1369 - 1376. [Abstract] [Full Text] [PDF]

				R. Kaw, F. Michota, A. Jaffer, S. Ghamande, D. Auckley, and J. Golish Unrecognized Sleep Apnea in the Surgical Patient: Implications for the Perioperative Setting Chest, January 1, 2006; 129(1): 198 - 205. [Abstract] [Full Text] [PDF]

				S. Ryan, C. T. Taylor, and W. T. McNicholas Selective Activation of Inflammatory Pathways by Intermittent Hypoxia in Obstructive Sleep Apnea Syndrome Circulation, October 25, 2005; 112(17): 2660 - 2667. [Abstract] [Full Text] [PDF]

				P. Lloberes, S. Marti, G. Sampol, A. Roca, T. Sagales, X. Munoz, and M. Ferrer Predictive Factors of Quality-of-Life Improvement and Continuous Positive Airway Pressure Use in Patients With Sleep Apnea-Hypopnea Syndrome: Study at 1 Year Chest, October 1, 2004; 126(4): 1241 - 1247. [Abstract] [Full Text] [PDF]

				V. Belozeroff, R. B. Berry, C. S. H. Sassoon, and M. C. K. Khoo Effects of CPAP therapy on cardiovascular variability in obstructive sleep apnea: a closed-loop analysis Am J Physiol Heart Circ Physiol, January 1, 2002; 282(1): H110 - H121. [Abstract] [Full Text] [PDF]

				J. L. PÉPIN, J. KRIEGER, D. RODENSTEIN, A. CORNETTE, E. SFORZA, P. DELGUSTE, C. DESCHAUX, V. GRILLIER, and P. LÉVY Effective Compliance during the First 3 Months of Continuous Positive Airway Pressure . A European Prospective Study of 121 Patients Am. J. Respir. Crit. Care Med., October 1, 1999; 160(4): 1124 - 1129. [Abstract] [Full Text]