Abstract
Introduction The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA). Yet the effects of CPAP obtained on the first night of use are underreported. Objective To evaluate the acute effects of CPAP on polysomnographic variables in patients with OSA. Materials and methods This study is a case series with 31 patients (55.8 ± 11.4 years; 22 men) in the initial phase of CPAP treatment. The subjects were evaluated by means of polysomnography with and without CPAP (10.2 ± 3.1 cmH2O) and without CPAP, on different days, by means of the following variables: sleep stages 1, 2 and 3 (N1, N2 and N3), rapid eye movement (REM) sleep, apnea and hypopnea index (AHI), AHI in REM sleep (AHIREM) and the micro-arousal index (MAI). Results The use of CPAP resulted in a reduction of N2 (p < 0.001), AHI (p < 0.001), AHIREM (p < 0.001) and MAI (p = 0.001). There was an increase in N3 (p = 0.006) and REM sleep (p < 0.001) during the night with use of CPAP. Conclusion This study demonstrated that, from the first night of use by patients with OSA, CPAP promotes greater balance between sleep phases, and improves sleep quality. These results should be presented to patients and their families in order to encourage greater adherence in the initial phase of treatment with CPAP.
Highlights
The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA)
This study is a case series whose participants included 31 patients with clinical diagnosis of OSA being treated at the Sleep Institute of Santa Maria (SISM), who were randomly selected between December 2012 and March 2013
The results showed reduction in AHI, AHI in REM sleep (AHIREM) and micro-arousal index (MAI) values
Summary
The use of non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is among the main therapeutic options for patients with obstructive sleep apnea (OSA). In OSA, the sleep phases are interrupted by episodes of apneas and hypopneas, which can result in reduced vitality and overall mental and physical health [4] These combined factors predispose patients to higher rates of morbidity and mortality [5, 6]. Among the main therapeutic options in the management of patients with OSA, non-invasive ventilation in the form of continuous positive airway pressure (CPAP) is indicated as the first line of treatment [7], with great results on quality of sleep and life [8], improved functional condition [9] and positive repercussions on cardiovascular risk and mortality rates [5]. Prescribed and used by physical therapists, the use of CPAP reduces episodes of apneas and hypopneas and levels of inflammatory markers such as C-reactive protein, tumor necrosis factor-α and Interleukin-6 [10]
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