Cerebral hemodynamics in patients with obstructive sleep apnea syndrome monitored with near-infrared spectroscopy (NIRS) during positive airways pressure (CPAP) therapy: a pilot study

2014 ◽  
Author(s):  
Zhongxing Zhang ◽  
Maja Schneider ◽  
Marco Laures ◽  
Ursula Fritschi ◽  
Isabella Lehner ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Infrared Spectroscopy ◽  
Sleep Apnea ◽  
Pilot Study ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Near-infrared spectroscopy (NIRS) as a useful tool to evaluate the treatment efficacy of positive airways pressure therapy in patients with obstructive sleep apnea syndrome (OSAS): A pilot study

2014 ◽  
Vol 07 (02) ◽  
pp. 1450014 ◽  
Author(s):  
Zhongxing Zhang ◽  
Maja Schneider ◽  
Ursula Fritschi ◽  
Isabella Lehner ◽  
Ramin Khatami
Keyword(s):  
Obstructive Sleep Apnea ◽  
Infrared Spectroscopy ◽  
Cardiovascular Risk ◽  
Treatment Efficacy ◽  
Near Infrared ◽  
Sleep Apnea Syndrome ◽  
Cerebral Hemodynamics ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Apnea Syndrome

In obstructive sleep apnea syndrome (OSA) the periodic reduction or cessation of breathing due to narrowing or occlusion of the upper airway during sleep leads to an impaired cerebral vascular autoregulation that is associated with an increased cardiovascular risk, including stroke. Continuous positive airways pressure (CPAP) therapy at night is the most effective treatment for OSA and has been shown to reduce the cardiovascular risk in OSA patients. However, there is no suitable bedside monitoring method evaluating the recovery of cerebral hemodynamics during CPAP therapy. Near-infrared spectroscopy (NIRS) is ideally suited for non-invasive monitoring the cerebral hemodynamics during sleep due to its properties of local measurement, totally safe application and good tolerance to motion. In this pilot study, we monitored cerebral hemodynamics during standard CPAP therapy at night in three patients with severe OSA using NIRS. We found periodic oscillations in HbO2, HHb, tissue oxygenation index (TOI) and blood volume (BV) associated with periodic apnea events without CPAP in all OSA patients. These oscillations were eliminated under the optimal CPAP pressures in all patients. These results suggested that the recovery of cerebral hemodynamics impaired by apnea events can be evaluated by bedside NIRS measurements in real time during all night CPAP therapy. NIRS is a useful bedside monitoring tool to evaluate the treatment efficacy of CPAP therapy in patients with OSA.

Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome

2007 ◽  
Vol 293 (4) ◽  
pp. R1666-R1670 ◽  
Author(s):  
Walter T. McNicholas
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
Cardiovascular Morbidity And Mortality ◽  
Apnea Syndrome ◽  
The Impact

Considerable evidence is now available of an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease. The association is particularly strong for systemic arterial hypertension, but there is growing evidence of an association with ischemic heart disease and stroke. The mechanisms underlying cardiovascular disease in patients with OSAS are still poorly understood. However, the pathogenesis is likely to be a multifactorial process involving a diverse range of mechanisms, including sympathetic overactivity, selective activation of inflammatory molecular pathways, endothelial dysfunction, abnormal coagulation, and metabolic dysregulation, the latter particularly involving insulin resistance and disordered lipid metabolism. Therapy with continuous positive airway pressure (CPAP) has been associated with significant benefits to cardiovascular morbidity and mortality, both in short-term studies addressing specific aspects of morbidity, such as hypertension, and more recently in long-term studies that have evaluated major outcomes of cardiovascular morbidity and mortality. However, there is a clear need for further studies evaluating the impact of CPAP therapy on cardiovascular outcomes. Furthermore, studies on the impact of CPAP therapy have provided useful information concerning the role of basic cell and molecular mechanisms in the pathophysiology of OSAS.

scholarly journals Effect of nasal CPAP therapy for obstructive sleep apnea syndrome.

1989 ◽  
Vol 40 (5) ◽  
pp. 416-421 ◽  
Author(s):  
Takayuki Yoshizawa ◽  
Keiji Kurashina ◽  
Iwao Sasaki ◽  
Kenzo Otsuka ◽  
Tsuneto Akashiba ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Cpap Therapy ◽  
Nasal Cpap ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals Effect of CPAP-therapy on bronchial and nasal inflammation in patients affected by obstructive sleep apnea syndrome

2011 ◽  
Vol 49 (2) ◽  
pp. 232-237
Author(s):  
D. Lacedonia ◽  
F.G. Salerno ◽  
G.E. Carpagnano ◽  
R. Sabato ◽  
A. Depalo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Induced Sputum ◽  
Cpap Therapy ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Nasal Inflammation

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) has been shown to be associated to upper and lower airways inflammation. Continuous positive airway pressure (CPAP) is the elective treatment of OSAS. The aim of the present study was to assess the effect of CPAP-therapy on airway and nasal inflammation. METHODS: In 13 non-smoking subjects affected by untreated OSAS and in 11 non-smoking normal volunteers, airway inflammation was detected by analyses of the induced sputum. In the OSAS group measurements were repeated after 1, 10 and 60 days of the appropriate CPAP treatment. In addition, in 12 subjects of the OSAS group, nasal inflammation was detected by the analysis of induced nasal secretions at baseline, and after 1, 10 and 60 days of CPAP treatment. RESULTS: OSAS patients, compared to normal controls, showed at baseline a higher percentage of neutrophils and a lower percentage of macrophages in the induced sputum. One, 10 and 60 days of appropriate CPAP-therapy did not change the cellular profile of the induced sputum. In addition, in the OSAS patients, the high neutrophilic nasal inflammation present under baseline conditions was not significantly modified by CPAP-therapy. Finally, no patients developed airway hyper-responsiveness after CPAP therapy. CONCLUSIONS: In OSAS subjects, the appropriate CPAP-therapy, while correcting the oxygen desaturation, does not modify the bronchial and nasal inflammatory profile.

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