Sleep Apnea Returns when CPAP Treatment Stops

CPAP benefits quickly reversed when machine withdrawn

(RxWiki News) Obstructive sleep apnea causes more than just bad sleep and daytime fatigue; it's also a serious health condition that leads to higher risk for stroke and many cardiovascular diseases.

Continuous Positive Airway Pressure (CPAP) machines are commonly used with sleep apnea patients, to increase the air flow needed for a good night's rest and beating the sleep disorder. But when people stop using the CPAP machine, the benefits reverse themselves almost immediately.

"Ongoing use of CPAP machine is critical."

At the Sleep Disorders Centre of the University Hospital in Zurich, Malcolm Kohler, MD led research which showed the quick recurrence of sleep apnea episodes when CPAP treatment stopped. Studying patients who had been previously diagnosed with obstructive sleep apnea and treated with CPAP, Kohler split the patients into two groups - those who continued CPAP, and those who stopped it. Each night, the patients underwent at-home assessments of respiration and oxygen saturation; researchers also assessed them for sleepiness, blood pressure, heart rate and other markers.

After only two weeks, a significant difference in sleep apnea problems was evident between the two groups. “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," Kohler said. “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.”

The research also found a significant increase in urinary catecholamines, hormones consistent with sympathetic nervous system activation. These findings imply that withdrawal of CPAP therapy for even a short time has a measurable negative effect on the cardiovascular system.

“We have shown that CPAP withdrawal leads to a return of OSA within the first night off CPAP,” said Dr. Kohler. “In addition to strongly suggesting that OSA patients should bring along their CPAP machines on holidays and other short periods away from home.

The findings appear online in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

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Review Date: 
August 15, 2011