Sleep architecture in patients with sleep apnea syndrome before CPAP therapy and at the background of CPAP

Abstract

The syndrome of sleep apnea appears to be one of the most prevalent forms of sleep disorders. The goal of the research was to study the peculiarities of sleep architecture in patients with the syndrome of sleep apnea before CPAP therapy and at the background of CPA. The investigations were carried out at P. Sarajishvili Institute of Neurology. A total of 17 patients, ages 28–65, with sleep apnea were examined, including 15 men and 2 women. All patients completed the a questionnaire for their Epworth Sleepness Score and their MBI was determined. For differential diagnostics of sleep apnea a polysomnography investigations (PSG) was carried out using Dr. Sagura Medizintechnik P59 polygraph accompanied by full video synchronized recording. For CPAP therapy the IntelliPAP AutoAdjust Travel CPAP Machine with SmartFlex (Manufactured by DeVilbiss) was used. According to the questionnaire all the patients have a high rate of night sleep disorders. Epworth Sleepness Score (20–22, maximum 24) and body mass index (BMI) overall maximum (31–45 > 31). The patients were characterized by night sleep disorder, loud snoring, headache, apathy, problems concentrating, excess daytime sleep. PSG investigation has shown that the patients with both obstructive sleep apnea (OSA) (14) and central sleep apnea (3) are characterized by significant decrease in sleep architecture, which results in full absence of the II stage of sleep (superficial sleep), the increase of REM stage, frequent EEG and EMG awakenings, and by the fragmentation of sleep as a whole. It should be noted that a separate part of OSA patients (both women and men) was characterized by clearly expressed REM behavioral disorders. Central sleep apnea was characterized by relatively low index of snoring (SI) (80–120) and relatively high indices of the saturation (SP02) (87–93) in cases of obstructive sleep apnea (SI>200, SP02-(36–91). At the background of CPAP therapy the first significant effect was received after 2 h resulting in the regulation of respiration and snore index. The progressive increase of SP02 was within the limits of 92–95%. Sleep architecture considerably changed, EEG and EMG awakenings sharply decreased, NREM stages increased, in rare cases when NREM3 stage was noted, sleep fragmentation significantly decreased. Thus, SA (both CSA and OSA) is characterized by significant disorder of sleep architecture. At the background of CPAP therapy a significant improvement of sleep architecture and the regulation of symptomocomplex characteristics of sleep apnea take place. Dr. Sagura Medizintechnik.