Obstructive sleep apnea returns quickly with a bang when use of continuous positive airway pressure machines are withdrawn, according to a new study.
"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.
The researchers found 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 "Withdrawal of CPAP was associated with a rapid return of sleep-disordered breathing within a few days," said Dr. Kohler.
The study has been published online in the articles-in-press section of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.