These novel findings suggest that overnight rostral fluid displacement from the legs, related to prolonged sitting, may play a previously unrecognized role in the pathogenesis of obstructive sleep apnea in nonobese men that is independent of body weight.
Background-Obstructive sleep apnea (OSA) and central sleep apnea are common in patients with heart failure. We hypothesized that in such patients, severity of OSA is related to overnight rostral leg fluid displacement and increase in neck circumference, severity of central sleep apnea is related to overnight rostral fluid displacement and to sleep PCO 2 , and continuous positive airway pressure alleviates OSA in association with prevention of fluid accumulation in the neck. Methods and Results-In 57 patients with heart failure (ejection fraction Յ45%), we measured change in leg fluid volume and neck circumference before and after polysomnography, and we measured transcutaneous PCO 2 during polysomnography. Patients were divided into an obstructive-dominant group (Ն50% of apneas and hypopneas obstructive) and a central-dominant group (Ͼ50% of events central
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