Effect of Ethanol on the Efficacy of Nasal Continuous Positive Airway Pressure as a Treatment for Obstructive Sleep Apnea

Berry, Richard B.; Desa, Margaret M.; Light, Richard W.

doi:10.1378/chest.99.2.339

Cited by 54 publications

(16 citation statements)

References 17 publications

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“…This was equally true of subjects with mild and severe OSAS, and was also true for the first 2 h, when the blood alcohol level would have been highest. This result conflicts with the findings of MITLER et al [12], who found a small increase in the pressure required to prevent snoring in nonapnoeic snorers, but is compatible with the results of BERRY et al [16], who found that there was no change in the AHI or Sa,O 2 with alcohol in subjects who were already on adequate CPAP. One possible explanation is that in patients with frank OSAS, as opposed to snoring, the upper airway is already almost totally floppy during sleep, and the existing pressure used for CPAP provides nearly all of the inspiratory support.…”

Section: Pressure Requirementcontrasting

confidence: 50%

“…MITLER et al [12] showed that 2 mL·kg -1 BW vodka produced a significant increase in the pressure required for CPAP from 4.8 to 6.2 cmH 2 O. However, when BERRY et al [16] tested 10 obese males with OSAS with nasal CPAP titration, there was no important change in the AHI (3.6±3.7 episodes·h -1 without ethanol, 1.9±2.7 episodes·h -1 with ethanol 0.75-1.0 mL·kg -1 BW), and there were no changes in the number or severity of desaturations.…”

mentioning

confidence: 98%

“…Potentially, alcohol consumption might be expected to change the continuous positive airway pressure (CPAP) requirements for the treatment of OSAS [2,12,16]. MITLER et al [12] showed that 2 mL·kg -1 BW vodka produced a significant increase in the pressure required for CPAP from 4.8 to 6.2 cmH 2 O.…”

mentioning

confidence: 99%

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Influence of moderate alcohol consumption on obstructive sleep apnoea with and without AutoSet nasal CPAP therapy

Teschler¹,

Berthon-Jones²,

Wessendorf³

et al. 1996

Eur Respir J

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I In nf fl lu ue en nc ce e o of f m mo od de er ra at te e a al lc co oh ho ol l c co on ns su um mp pt ti io on n o on n o ob bs st tr ru uc ct ti iv ve e s sl le ee ep p a ap pn no oe ea a w wi it th h a an nd d w wi it th ho ou ut t A Au ut to oS Se et t " " n na as sa al l C CP PA AP P t th he er ra ap py y Fourteen adult males with untreated OSAS but without heart or lung disease were studied (age 53±9 yrs, body mass index (BMI) 33±5 kg·m -2 (mean±SD). The subjects underwent overnight polysomnography on four occasions: control, alcohol, CPAP, and alcohol + CPAP. On the alcohol nights, the subjects drank 1.5 mL·kg -1 body weight (BW) vodka (40% alcohol by volume) (blood alcohol with and without CPAP 0.45±0.1 and 0.47±0.2 mg·mL -1 (mean±SD)). On the CPAP nights, the pressure required to prevent apnoea, snoring, and silent inspiratory airflow limitation was determined using an autotitrating nasal CPAP system (ResCare AutoSet™). Alcohol and control nights were performed in random order.Without CPAP, alcohol produced a small non-significant decrease in the percentage of rapid eye movement (REM) sleep (control 11±2 vs alcohol 8±1% (mean±SEM)), but with CPAP there was no such effect (control 15±2 vs 17±2%; CPAP×alcohol interaction p=0.015). With CPAP, slow-wave sleep in the first 2 h increased slightly with alcohol (control 39±6 vs alcohol 51±4%; p=0.004). Arousal index without CPAP increased slightly with alcohol (control 43±5 vs alcohol 49±6 events·h -1 ; p=0.02). There was little or no effect of alcohol on other sleep stages, arousal index, apnoea index, apnoea/hypopnoea index, mean or longest event duration, mean or worst arterial oxygen saturation, with or without CPAP, either for the full night or for the first 2 h. There was no change in the pressure requirement for CPAP (full night: control 11.9±0.9 vs alcohol 12.5±0.9 cmH 2 O; first 2 h: 10.9±0.6 vs 11.1±0.8 cmH 2 O).Moderate alcohol intake (in the form of vodka) has little effect on breathing or saturation during sleep in subjects with mild-to-severe obstructive sleep apnoea, and no effect on the pressure required for continuous positive airway pressure in order to prevent apnoea, snoring, and flow limitation. These results cannot be extrapolated to other doses or forms of alcohol, or to subjects with concurrent heart or lung disease.

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Section: Pressure Requirementcontrasting

confidence: 50%

mentioning

confidence: 98%

See 1 more Smart Citation

Influence of moderate alcohol consumption on obstructive sleep apnoea with and without AutoSet nasal CPAP therapy

Teschler¹,

Berthon-Jones²,

Wessendorf³

et al. 1996

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Many studies have demonstrated harmful effects on nocturnal respiration, including increased number and duration of hypopnea and apnea events [19,[52][53][54]. In continuous positive airway pressure titration experiment, moderate alcohol consumption increased the level of pressure necessary to prevent OSA [55]. The effect of alcohol is that upper airway muscle tone is reduced by even quite small amounts of alcohol [56].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of sleep apnea in HRH Princess Maha Chakri Srinthorn Medical Center, Thailand

Neruntarat

Chantapant

2010

Sleep Breath

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“…Alcohol, consumed in large quantities (>1.0 g alcohol/kg BW/day), sufficient to increase the blood alcohol concentrations (BAC) to >0.075 g/dl, increases apnea frequency, and duration and is associated with hypoxemia in patients with OSA (8)(9)(10)(11). However, the effects of alcohol at lower doses (0.5-1.0 g alcohol/kg BW) on OSA are less clear.…”

Section: Introductionmentioning

confidence: 99%

Effect of moderate alcohol intake on nocturnal sleep respiratory parameters in healthy middle-aged men

Izumi

Nasermoaddeli

Sekine

et al. 2005

Environ Health Prev Med

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Purpose: It is known that a moderate to large volume of alcohol produces deterioration in obstructive sleep apnea (OSA), however, no consensus has been achieved with respect to the influence of a moderate volume of alcohol on mild to moderate OSA. In this study, we investigated the influence of alcohol on OSA-associated parameters in healthy middle-aged males drinking a moderate volume of alcohol (<1 g alcohol/kg bodyweight per day).Methods: Subjects were 23 healthy males (mean age of 46.0) with a habitual ingestion of moderate amounts of alcohol. Respiratory sleep parameters were measured through the fitting of an Apnomonitor III (Chest Inc.) and portable sleep monitoring device (Actiwatch: AMI Inc.) to subjects on three nights; an alcohol-free night, a night on which they drank alcohol with dinner, and a night on which they drank alcohol within 30 minutes before retiring to bed. The measurements were categorized into the early and late halves of assumed sleep for analysis.Results: The apnea-hypopnea index was significantly higher when drinking alcohol before retiring Conclusion: These results suggest that moderate ingestion of alcohol within 30 minutes before retiring aggravates OSA-associated parameters in healthy males.

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Effect of Ethanol on the Efficacy of Nasal Continuous Positive Airway Pressure as a Treatment for Obstructive Sleep Apnea

Cited by 54 publications

References 17 publications

Influence of moderate alcohol consumption on obstructive sleep apnoea with and without AutoSet nasal CPAP therapy

Influence of moderate alcohol consumption on obstructive sleep apnoea with and without AutoSet nasal CPAP therapy

Prevalence of sleep apnea in HRH Princess Maha Chakri Srinthorn Medical Center, Thailand

Effect of moderate alcohol intake on nocturnal sleep respiratory parameters in healthy middle-aged men

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