Effects of continuous positive airway pressure therapy withdrawal in patients with obstructive sleep apnea A randomized controlled trial

American Journal of Respiratory and Critical Care Medicine

Volumn 184, Issue 10, 2011, Pages 1192-1199

  Kohler, Malcolm ^a,b   Stoewhas, Anne Christin ^a   Ayers, Lisa ^c   Senn, Oliver ^b   Bloch, Konrad E ^a,b   Russi, Erich W ^a,b   Stradling, John R ^c  

^a UNIVERSITY HOSPITAL ZURICH   (Switzerland)

^b UNIVERSITY OF ZURICH   (Switzerland)

^c CHURCHILL HOSPITAL   (United Kingdom)

Author keywords

Blood pressure; Continuous positive airway pressure; Endothelial function; Obstructive sleep apnea; Therapy

Indexed keywords

CATECHOLAMINE; INSULIN; LIPID; PLACEBO;

ADULT; ARTICLE; CATECHOLAMINE URINE LEVEL; CLINICAL ARTICLE; CONTROLLED STUDY; DIASTOLIC BLOOD PRESSURE; DISEASE MARKER; FEMALE; HEART RATE; HUMAN; INFLAMMATION; INSULIN RESISTANCE; LIPID BLOOD LEVEL; MALE; METABOLISM; POLYSOMNOGRAPHY; POSITIVE END EXPIRATORY PRESSURE; PRIORITY JOURNAL; PSYCHOMOTOR PERFORMANCE; RANDOMIZED CONTROLLED TRIAL; RECURRENT DISEASE; SLEEP APNEA SYNDROME; SOMNOLENCE; SYSTOLIC BLOOD PRESSURE; TREATMENT WITHDRAWAL;

ACTIGRAPHY; BIOLOGICAL MARKERS; BLOOD PRESSURE; CONTINUOUS POSITIVE AIRWAY PRESSURE; DISORDERS OF EXCESSIVE SOMNOLENCE; ENDOTHELIUM, VASCULAR; FEMALE; HEART RATE; HUMANS; INFLAMMATION; INSULIN RESISTANCE; MALE; MIDDLE AGED; POLYSOMNOGRAPHY; PSYCHOMOTOR PERFORMANCE; RECURRENCE; SLEEP APNEA, OBSTRUCTIVE;

EID: 81455128860     PISSN: 1073449X     EISSN: 15354970     Source Type: Journal    
DOI: 10.1164/rccm.201106-0964OC     Document Type: Article

References (43)

1. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002;165:1217-1239. (Pubitemid 34461732)
2. Siccoli MM, Pepperell JC, Kohler M, Craig SE, Davies RJ, Stradling JR. Effects of continuous positive airway pressure on quality of life in patients with moderate to severe obstructive sleep apnea: data from a randomized controlled trial. Sleep 2008;31:1551-1558.
3. George CF. Reduction in motor vehicle collisions following treatment of sleep apnoea with nasal CPAP. Thorax 2001;56:508-512. (Pubitemid 32588527)
4. Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol 2010;7:677-685.
5. Haentjens P, Van Meerhaeghe A, Moscariello A, De Weerdt S, Poppe K, Dupont A, Velkeniers B. The impact of continuous positive airway pressure on blood pressure in patients with obstructive sleep apnea syndrome: evidence from a meta-analysis of placebo-controlled randomized trials. Arch Intern Med 2007;167:757-764.
6. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365:1046-1053. (Pubitemid 40386782)
7. Redline S, Yenokyan G, Gottlieb DJ, Shahar E, O'Connor GT, Resnick HE, Diener-West M, Sanders MH, Wolf PA, Geraghty EM, et al. Obstructive sleep apnea-hypopnea and incident stroke. Am J Respir Crit Care Med 2010;182:269-277.
8. Gottlieb DJ, Yenokyan G, Newman AB, O'Connor GT, Punjabi NM, Quan SF, Redline S, Resnick HE, Tong EK, Diener-West M, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure. Circulation 2010;122:352-360.
9. Kohler M, Pepperell JCT, Casadei B, Craig S, Crosthwaite N, Stradling JR, Davies RJO. CPAP and measures of cardiovascular risk in males with OSAS. Eur Respir J 2008;32:1488-1496.
10. Ryan CF, Lowe AA, Li D, Fleetham JA. Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after chronic nasal continuous positive airway pressure therapy. Am Rev Respir Dis 1991;144:939-944.
11. Grunstein RR, Stewart DA, Lloyd H, Akinci M, Cheng N, Sullivan CE. Acute withdrawal of nasal CPAP in obstructive sleep apnea does not cause a rise in stress hormones. Sleep 1996;19:774-782. (Pubitemid 27131927)
12. Bonsignore MR, Parati G, Insalaco G, Marrone O, Castiglioni P, Romano S, Di Rienzo M, Mancia G, Bonsignore G. Continuous positive airway pressure treatment improves baroreflex control of heart rate during sleep in severe obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2002;166:279-286. (Pubitemid 34864414)
13. Ip MSM, Tse HF, Lam B, Tsang KWT, Lam WK. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med 2004;169:348-353. (Pubitemid 38134813)
14. Phillips CL, Yang Q, Williams A, Roth M, Yee BJ, Hedner JA, Berend N, Grunstein RR. The effect of short-term withdrawal from continuous positive airway pressure therapy on sympathetic activity and markers of vascular inflammation in subjects with obstructive sleep apnoea. J Sleep Res 2007;16:217-225. (Pubitemid 46850092)
15. Phillips CL, Yee B, Yang Q, Villaneuva AT, Hedner J, Berend N, Grunstein R. Effects of continuous positive airway pressure treatment and withdrawal in patients with obstructive sleep apnea on arterial stiffness and central BP. Chest 2008;134:94-100. (Pubitemid 352008769)
16. Gokce N, Keany JF Jr, Hunter LM, Watkins MT, Menzoian MO, Vita JA. Risk stratification for postoperative cardiovascular events via noninvasive assessment of endothelial function: a prospective study. Circulation 2002;105:1567-1572. (Pubitemid 34297634)
17. Kohler M, Craig SE, Pepperell JCT, Nicoll D, Bratton D, Nunn A, Davies RJO, Stradling JR. CPAP improves endothelial function in minimally symptomatic OSA patients: results from the MOSAIC trial [abstract]. Thorax 2010;65:A9-A10.
18. Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. NIMH Publication 204. Washington, DC: U.S. Government Printing Office; 1968.
19. Jenkinson C, Davies RJ, Mullins R, Stradling JR. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial. Lancet 1999;353:2100-2105. (Pubitemid 29278478)
20. Pepperell JCT, Ramdassingh-Dow S, Crosthwaite N, Mullins R, Jenkinson C, Stradling JR, Davies RJO. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet 2002;359:204-210. (Pubitemid 34113817)
21. Bloch KE, Schoch OD, Zhang JN, Russi EW. German version of the Epworth Sleepiness Scale. Respiration 1999;66:440-447. (Pubitemid 29431578)
22. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991;14:540-545.
23. Bennett LS, Stradling JR, Davies RJ. A behavioural test to assess daytime sleepiness in obstructive sleep apnoea. J Sleep Res 1997;6:142-145. (Pubitemid 27300273)
24. Juniper M, Hack MA, George CF, Davies RJ, Stradling JR. Steering simulation performance in patients with obstructive sleep apnoea and matched control subjects. Eur Respir J 2000;15:590-595. (Pubitemid 30158201)
25. Dinges DF, Powell JW. Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations. Behav Res Methods Instrum Comput 1985;17:652-655.
26. Cole RJ, Kripke DF, Gruen W, Mullaney DJ, Gillin JC. Automatic sleep/wake identification from wrist actigraphy. Sleep 1992;15:461-469.
27. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340:1111-1115.
28. West SD, Nicoll DJ, Wallace TM, Matthews DR, Stradling JR. The effect of CPAP on insulin resistance and HbA1c in men with obstructive sleep apnoea and type 2 diabetes. Thorax 2007;62:969-974. (Pubitemid 350084496)
29. Peaston RT. Routine determination of urinary catecholamines by high performance liquid chromatography with electrochemical detection. J Chromatogr A 1988;424:263-272. (Pubitemid 18058841)
30. Kribbs NB, Pack AI, Kline LR, Getsy JE, Schuett JS, Henry JN, Maislin G, Dinges DF. Effects of one night without nasal CPAP treatment on sleep and sleepiness in patients with obstructive sleep apnea. Am Rev Respir Dis 1993;147:1162-1168. (Pubitemid 23149873)
31. Sforza E, Lugaresi E. Daytime sleepiness and nasal continuous positive airway pressure therapy in obstructive sleep apnea syndrome patients: effects of chronic treatment and 1-night therapy withdrawal. Sleep 1995;18:195-201.
32. Yang Q, Phillips CL, Melehan KL, Rogers NL, Seale JP, Grunstein RR. Effects of short-term CPAP withdrawal on neurobehavioral performance in patients with obstructive sleep apnea. Sleep 2006;29:545-552. (Pubitemid 44019943)
33. Turkington PM, Sircar M, Saralaya D, Elliott MW. Time course of changes in driving simulator performance with and without treatment in patients with sleep apnoea hypopnoea syndrome. Thorax 2004;59:56-59. (Pubitemid 38067973)
34. Cross MD, Mills NL, Al-Abri M, Riha R, Vennelle M, Mackay TW, Newby DE, Douglas NJ. Continuous positive airway pressure improves vascular function in obstructive sleep apnoea/hypopnoea syndrome: a randomised controlled trial. Thorax 2008;63:578-583. (Pubitemid 351969249)
35. Alonso-Fernandez A, Garcia-Rio F, Arias MA, Hernanz A, De la Pena M, Pierola J, Barcelo A, Lopez-Collazo E, Agusti A. Effects of CPAP on oxidative stress and nitrate efficiency in sleep apnoea: a randomised trial. Thorax 2009;64:581-586.
36. Drager LF, Bortolotto LA, Figueiredo AC, Krieger EM, Lorenzi-Filho G. Effects of continuous positive airway pressure on early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med 2007;176:706-712. (Pubitemid 47503079)
37. Kohler M, Ayers L, Pepperell JCT, Packwood KL, Ferry B, Crosthwaite N, Craig S, Siccoli MM, Davies RJO, Stradling JR. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial. Thorax 2009;64:67-73.
38. Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, Hirano T, Adachi M. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation 2003;107:1129-1134. (Pubitemid 36297204)
39. Ryan S, Taylor CT, McNicholas WT. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 2005;112:2660-2667. (Pubitemid 41532603)
40. Levy P, Bonsignore MR, Eckel J. Sleep, sleep-disordered breathing and metabolic consequences. Eur Respir J 2009;34:243-260.
41. Pialoux V, Hanly PJ, Foster GE, Brugniaux JV, Beaudin AE, Hartmann SE, Pun M, Duggan CT, Poulin MJ. Effects of exposure to intermittent hypoxia on oxidative stress and acute hypoxic ventilatory response in humans. Am J Respir Crit Care Med 2009;180:1002-1009.
42. Tamisier R, Gilmartin GS, Launois SH, Pepin JL, Nespoulet H, Thomas R, Levy P, Weiss JW. A new model of chonic intermittent hypoxia in humans: effect on ventilation, sleep, and blood pressure. J Appl Physiol 2009;107:17-24.
43. Louis M, Punjabi NM. Effects of acute intermittent hypoxia on glucose metabolism in awake healthy volunteers. J Appl Physiol 2009;106:1538-1544.