Effects of Continuous Positive Airway Pressure on Sleep EEG Characteristics in Patients with Primary Central Sleep Apnea Syndrome

This study aimed to investigate the effects of continuous positive airway pressure (CPAP) on the electroencephalographic (EEG) characteristics of patients with primary central sleep apnea syndrome (CSAS). Nine patients with primary CSAS were enrolled in this study. The raw sleep EEG data were analyzed based on two main factors: fractal dimension (FD) and zero-crossing rate of detrended FD. Additionally, conventional EEG spectral analysis in the delta, theta, alpha, and beta bands was conducted using a fast Fourier transform. The FD in patients with primary CSAS who underwent CPAP treatment was significantly decreased during nonrapid eye movement (NREM) sleep but increased during rapid eye movement (REM) sleep ( p < 0.05 ). Regarding the EEG spectral analysis, the alpha power increased, while the delta/alpha ratio decreased during REM sleep in patients with CSAS ( p < 0.05 ). In conclusion, CPAP treatment can reduce FD in NREM sleep and increase FD during REM sleep in patients with primary CSAS. FD may be used as a new biomarker of EEG stability and improvement in brain function after CPAP treatment for primary CSAS.

RELATIONSHIP AND IMPACTS OF CENTRAL SLEEP APNEA SYNDROME IN PEOPLE WITH HEART FAILURE: A BIBLIOGRAPHIC REVIEW

Central sleep apnea (CSA) is a disorder of the central ventilatory control of the nervous system characterized by prolonged episodes of apnea during the individual’s sleep period. One of the etiologies described by several scientific studies for this condition is congestive heart failure (CHF), a disease of big prevalence and relevance for contemporary medicine. This article, in addition to describing the significant aspects of sleep physiology to the current study, seeks to correlate the sleep process with the mechanisms involved in the pathophysiology of CSA in patients with CHF, as well as the impacts on the quality of life of these people.

0633 Volume Assured Pressure Support is an Effective Treatment in Patients with Central Sleep Apnea Syndrome

Introduction Central sleep apnea syndrome (CSA) is commonly found in patients with congestive heart failure, brainstem disorders, and narcotic use. Various treatment modalities have been used with varied effectiveness in reducing the apnea-hypopnea index (AHI) and improving ventilation in patients with CSA. This study assessed whether Volume Assured Pressure Support (VAPS), a BiLevel mode of ventilation, is effective in treating CSA. Methods We performed a retrospective review of polysomnography (PSG) and VAPS titration studies on 11 patients at our institution: 7 patients had CSA with Cheyne-Stokes Respiration, 2 patients had CSA attributed to narcotic use, and 2 patients had primary CSA. CSA was diagnosed if more than 50% of the disordered breathing events were central. Five patients had failed a Continuous Positive Airway Pressure (CPAP) titration and then proceeded to VAPS while in 6 patients, VAPS was the initial treatment modality tried. We examined the effectiveness of VAPS in reducing AHI, improving oxygenation, and improving sleep architecture. Results Among the 11 patients, age was 63.0±12.1 yo, BMI was 33.7 ±4.5, 7 were males, Epworth sleepiness score was 9.3±4.9. The following significant changes from baseline PSG to VAPS titration were observed: AHI: 59.1± 8.0 to 27.2 ± 9.9 (p&lt;.01); Time ≤ 88% O2 saturation (min): 48.1±14.5 to 15.4±6.1 (p&lt;.05). Improvement in AHI was not related to gender, body mass index, narcotic use, or age. No significant changes in sleep architecture between the two studies were found. Ten (91%) patients had AHI &gt; 30 on initial PSG. In 6 (55%) patients AHI was reduced to &lt;15 with VAPS use. An additional patient had AHI reduced to 22.2, while 4 (36%) patients did not achieve an AHI &lt; 30 with VAPS. Conclusion VAPS is an effective mode of treating CSA in the majority of patients. Support NA