joi, 15 decembrie 2011

Sleep Apnea - CPAP Face Mask Improves Overall Cardiovascular Health

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Main Category: Sleep / Sleep Disorders / Insomnia
Article Date: 15 Dec 2011 - 8:00 PST

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Patients with obstructive sleep apnea who use a face mask during their slumber hours were found to have significantly improved blood pressure, levels of stomach fat (visceral fat), and cholesterol and blood sugar levels - all factors closely related to metabolic syndrome and heart health, researchers reported in NEJM (New England Journal of Medicine).

As background information, the authors explain that approximately 18 million people in the USA live with obstructive sleep apnea. Many sufferers are unaware of their condition, because they are asleep when the breathing is halted - whoever sleeps with them is generally the first to notice.

Obstructive sleep apnea (British spelling: apnoea), also known as OSA is a disorder of sleep in which the sufferer stops breathing for at least ten seconds while asleep. The throat muscles (soft tissue in the back of the throat) collapse and close, resulting in blocked airways. Each episode of halted breathing is called an apnea. Apnea means without breath.

Patients with sleep apnea may wake up during an apnea, but are rarely aware of their problem - they do not know why they woke up.

Obstruction ventilation apnée sommeil
During an "apnea" the airway becomes blocked

Standard treatment involves a CPAP machine - this includes a mask that is attached to continuous airway pressure. A significant proportion of CPAP machine users stop using them within a year because they are cumbersome devices.

Lead author, Surendra Sharma, from the All India Institute of Medical Sciences in New Delhi, said:

"These patients need to be properly counseled for regular use of CPAP machines. In a real- life situation, the machine will be used for a longer period and more benefits will be observed."

Pharmaceutical giant, Pfizer Inc. funded the trial. Clinical trials government number NCT00694616. The company does not make or sell sleep apnea devices.

CPAPmask
A CPAP mask (Source: Philips)

Obstructive sleep apnea patients were randomly selected to have therapeutic CPAP followed by placebo CPAP (sham CPAP). This was followed by a 1-month washout period, after which the groups swapped (the placebo ones used the mask for three months, while the other group used the placebo).

At the beginning and end of each three-month intervention, the researchers took measurements of the participants' blood pressure, insulin resistance, fasting blood sugar (glucose) levels, fasting blood lipid profile, visceral fat, carotid intima-media thickness, and glycated hemoglobin levels.

The authors reported the following results on 86 patients who completed the trial; 87% of whom had metabolic syndrome: Those on the CPAP treatment had considerable improvements in the following readings, compared to those on sham CPAP in the following:

- Systolic blood pressure
- Diastolic blood pressure
- Serum total cholesterol
- Non-high-density lipoprotein cholesterol
- Low-density lipoprotein cholesterol
- Triglycerides

Metabolic syndrome reversal was found in 11 of 86 patients on CPAP therapy, compared to 1 of 86 on sham CPAP therapyThe authors concluded in an Abstract in the journal:
"In patients with moderate-to-severe obstructive sleep apnea syndrome, 3 months of CPAP therapy lowers blood pressure and partially reverses metabolic abnormalities."

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our sleep / sleep disorders / insomnia section for the latest news on this subject. "CPAP for the Metabolic Syndrome in Patients with Obstructive Sleep Apnea"
Surendra K. Sharma, M.D., Ph.D., Swastik Agrawal, M.D., Deepak Damodaran, M.D., Vishnubhatla Sreenivas, Ph.D., Tamilarasu Kadhiravan, M.D., Ramakrishnan Lakshmy, Ph.D., Priya Jagia, M.D., and Atin Kumar, M.D.
N Engl J Med 2011; 365:2277-2286December 15, 2011 Please use one of the following formats to cite this article in your essay, paper or report:

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Christian Nordqvist. "Sleep Apnea - CPAP Face Mask Improves Overall Cardiovascular Health." Medical News Today. MediLexicon, Intl., 15 Dec. 2011. Web.
15 Dec. 2011. APA

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