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Withdrawal of CPAP therapy results in rapid recurrence of OSA
Date:8/11/2011

The benefits of continuous positive airway pressure machines (CPAP) for patients with obstructive sleep apnea (OSA) are quickly reversed when the therapy is withdrawn, according to Swiss research.

The findings appear online in the articles-in-press section of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

"In patients with obstructive sleep apnea who are established on CPAP treatment, withdrawal of the therapy is associated with a rapid recurrence of OSA and sleepiness within a few days" said Malcolm Kohler, MD, senior consultant at the Sleep Disorders Centre and Pulmonary Division of the University Hospital in Zurich. "After 14 days of CPAP withdrawal, OSA patients experienced considerable increases in heart rate and blood pressure as well as a deterioration in vascular function."

The researchers recruited patients who had been previously diagnosed with OSA and treated with CPAP and were registered in a database of the Sleep Disorders Centre in Zurich. Patients were randomized to either continue CPAP therapy or to withdraw CPAP (maintaining a sub-therapeutic level) for two weeks. After baseline polysomnography, patients underwent nightly at-home assessment of respiration and oxygen saturation each day of the study period. Patients were also assessed for subjective and objective sleepiness, psychomotor performance, blood pressure and heart rate, endothelial function (a marker of vascular function), systemic inflammation, insulin resistance and urinary catecholamines (a marker of sympathetic nervous system activity.) The polysomnography was repeated at the end of the two-week period.

Not surprisingly, at the end of the study period there was a significant increase in apneic events, oxygen desaturations and the number of arousals during sleep. As a consequence of the recurrence of sleep-disordered breathing, subjective sleepiness increased in the CPAP withdrawal group "Withd
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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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