Sleep and Breathing

, Volume 9, Issue 1, pp 12–19

Effect of CPAP treatment on inspiratory arousal threshold during NREM sleep in OSAS

Authors

  • José Haba-Rubio
    • Sleep Disorders UnitUniversity Hospital
  • Emilia Sforza
    • Sleep Disorders UnitUniversity Hospital
  • Thomas Weiss
    • Sleep Disorders UnitUniversity Hospital
  • Carmen Schröder
    • Sleep Disorders UnitUniversity Hospital
    • Sleep Disorders UnitUniversity Hospital
    • Clinique Neurologique
Original Article

DOI: 10.1007/s11325-005-0002-5

Cite this article as:
Haba-Rubio, J., Sforza, E., Weiss, T. et al. Sleep Breath (2005) 9: 12. doi:10.1007/s11325-005-0002-5

Abstract

The maximal inspiratory effort recorded at the end of apnea has been considered as an index of arousal threshold in obstructive sleep apnea syndrome (OSAS). Previous investigations have shown that the arousal threshold is higher in patients with OSAS than in normal subjects. The aim of the present study was to investigate the effect of continuous positive airway pressure (CPAP) treatment on the inspiratory-effort-related arousal threshold in patients with OSAS. In ten male patients, 40 episodes of apnea during stage 2 non-REM (NREM) sleep were analyzed. Apnea duration (t), esophageal pressure (Pes) at the first occluded breath (Pes1), the minimum of the three initial Pes swings (Pes min), the maximum of the three final Pes swings (Pes Max), ΔPes (Pes Max−Pes min), RPes (rate of increase of intrathoracic pressure, ΔPes/t), n (number of occluded breaths during apnea), ΔPes/n, n/t, and SaO2 were determined before and after occlusion. These apneic episodes were compared to ten episodes of apnea provoked by a mask occlusion device after 1, 7, 30, and 90 days of CPAP treatment. The therapy resulted in a decrease in the inspiratory-effort-related arousal threshold, as measured by a reduction of Pes Max, without significant changes in apnea duration and apnea-related hypoxemia. Pes1 and ΔPes/n, which are markers of respiratory drive, significantly decreased between observations. CPAP treatment decreases the inspiratory-effort-related arousal threshold and induces a decrease in ventilatory drive in response to upper airway occlusion.

Keywords

Obstructive sleep apneaArousalContinuous positive airway pressure

Copyright information

© Springer-Verlag 2005