Effects of nocturnal oxygen therapy on sleep apnea syndrome in peritoneal dialysis patients

Kumagai, Takiko; Ishibashi, Yutaka; Kawarazaki, H; Kawarazaki, Wakako; Shimizu, Hayato; Kaname, Shinya; Fujita, Tomoe

doi:10.5414/cnp70332

Cited by 18 publications

(13 citation statements)

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“…Evidence has been presented for a tenfold higher prevalence of sleep apnoea (57%) in uraemic patients [3] than in people with normal renal function (2-4%) [25]. Obese people suffer more from sleep apnoea.…”

Section: Discussionmentioning

confidence: 99%

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Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

Yngman-Uhlin

Johansson

Fernström

et al. 2011

Scandinavian Journal of Urology and Nephrology

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Objective: The aim of this study was to describe the sleep-wake cycle, sleep quality, fatigue and HRQoL measured with questionnaires, actigraphy and sleep a diary during a one-week period in patients with peritoneal dialysis treatment at home. Further, to explore differences compared to patients with coronary artery disease (CAD) and individuals from the general population. Material and Methods:In this study one week, actigraphy registration, four questionnaires (Uppsala Sleep Inventory, SF-36, FACIT-fatigue, International Restless Legs Study Groups´ form) and a sleep diary were used. Results:In total data from 68 participants and 470 nights were collected. PD-patients (n=28) had more fragmented sleep (p<0.001) and worse sleep efficiency (SE) (p<0.0001) compared to the CAD (n=22) and the population (n=18) groups. Pruritus (57%), restless legs (46%) and fatigue (89%) were prevalent in PD-patients. Pruritus correlated to fragmented sleep (r=-0.45, p=0.01) and SE (r=-0.49, p =0.01). In HRQoL, the physical component score was decreased in the PD and angina groups (p<0.01) compared to the population group.Conclusions: To our knowledge this study is the first to demonstrate that PD-patients have a deteriorated sleep with serious fragmentation measured with a one-week actigraphy registration. Further, PD-patients exhibit worse sleep quality compared to CAD patients and individuals in the population. More evaluation of sleep in clinical practice is highly recommended since PD-patients are vulnerable individuals with extended self-care responsibilities and at risk for co-morbidity secondary to insufficient. Future research on whether PD-patient´ sleep problems and fatigue can be improved by an individual nonpharmacological intervention programme is required.3

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Section: Discussionmentioning

confidence: 99%

“…Potential sleep disturbing factors are pruritus and restless legs syndrome (RLS) with a prevalence of 55% and 30%, respectively [1]. In addition, high rates (57%) of sleep apnoea in PD-patients have been reported [3]. Decreased sleep quality changes both metabolic [4] and immunological [5,6] functions.…”

Section: Introductionmentioning

confidence: 99%

Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

Yngman-Uhlin

Johansson

Fernström

et al. 2011

Scandinavian Journal of Urology and Nephrology

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“…Two studies 23,33 used AHI > 5; 5 studies 24-28 used AHI > 15; one study 32 used SDB event > 50/h, and one study 35 used RDI > 20 for OSA patient selection. Four studies 30,31,34,36 selected patients with a confirmed diagnosis of OSA following overnight PSG with no description of any specific AHI criteria. Most of the patients were male, accounting for 89% of the study population.…”

Section: Study Characteristicsmentioning

confidence: 99%

Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis

Mehta

Vasu

Phillips

et al. 2013

Journal of Clinical Sleep Medicine

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“…13,35 The latter entities are of increasing importance in the US veteran population due to the increased use of prescription opioid drugs for chronic pain control and the risk for opioid related deaths. 34 Central apnea (CA), defi ned as the cessation of breathing with an absence of respiratory effort, occurs as cycles of apnea alternating with hyperpnea. The ventilatory overshoot in the recovery period leads to hypocapnia and recurrent apneas.…”

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confidence: 99%

Treatment of Central Sleep Apnea in US Veterans

Chowdhuri

Ghabsha

Sinha

et al. 2012

Journal of Clinical Sleep Medicine

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Background: There are no standard therapies for the management of central sleep apnea (CSA). Either positive pressure therapy (PAP) or supplemental oxygen (O 2 ) may stabilize respiration in CSA by reducing ventilatory chemoresponsiveness. Additionally, increasing opioid use and the presence of comorbid conditions in US veterans necessitates investigations into alternative titration protocols to treat CSA. The goal was to report on the effectiveness of titration with PAP, used alone or in conjunction with O 2 , for the management of CSA associated with varying comorbidities and opioid use. Methods: This was a retrospective chart review over 3 years, performed at a VA sleep disorders center. The effects of CPAP, CPAP+O 2 , and BPAP+O 2 , used in a step-wise titration protocol, on consecutive patients diagnosed with CSA were studied. Results: CSA was diagnosed in 162 patients. The protocol was effective in eliminating CSA (CAI ≤ 5/h) in 84% of patients. CPAP was effective in 48%, while CPAP+O 2 combination was effective in an additional 25%, and BPAP+O 2 in 11%. The remaining 16% were non-responders. Forty-seven patients (29%) were on prescribed opioid therapy for chronic pain, in whom CPAP, CPAP+O 2 , or BPAP+O 2 eliminated CSA in 54%, 28%, and 10% cases,, respectively. CPAP, CPAP+O 2 , and BPAP+O 2 each produced signifi cant declines in the AHI, CAI, and arousal index, and an increase in the SpO 2 .Conclusion: The data demonstrate that using a titration protocol with CPAP and then PAP with O 2 effectively eliminates CSA in individuals with underlying comorbid conditions and prescription opioid use. Comparative studies with other therapeutic modalities are required. S C I E N T I F I C I N V E S T I G A T I O N ST he treatment of central sleep apnea (CSA) continues to lack a universally recognized standard of care.1 Variable etiologies of CSA and the presence of concomitant disorders infl uence the choice of therapy. Thus, therapeutic options have varied markedly from positive airway pressure (PAP) devices, including continuous positive airway pressure (CPAP), 2-6 bilevel positive airway pressure therapy (BPAP), 7-9 and adaptive servoventilation, [10][11][12][13]20 to supplemental O 2 , 14-17 carbon dioxide, 21,22 and/or pharmacologic agents. [23][24][25]29,30 The outcomes of therapy have also varied considerably, with limited evidence to establish the effectiveness of any therapy for CSA. [26][27][28][29]31,32 The majority of published literature has focused on the treatment of CSA secondary to congestive heart failure (CHF), [2][3][4][5][6][7][8][9][10][11][15][16][17][18][19][20][21][22][26][27][28][29] with very little data on patients with "primary" CSA 23,24 or CSA secondary to causes other than CHF. 33 In addition, there is very little data on the treatment of CSA related to opioid use and CSA that is concomitant with OSA. 13,35 The latter entities are of increasing importance in the US veteran population due to the increased use of prescription opioid drugs for chronic pain control and the risk for opioi...

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Effects of nocturnal oxygen therapy on sleep apnea syndrome in peritoneal dialysis patients

Cited by 18 publications

References 0 publications

Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

Fragmented sleep: An unrevealed problem in peritoneal dialysis patients

Obstructive Sleep Apnea and Oxygen Therapy: A Systematic Review of the Literature and Meta-Analysis

Treatment of Central Sleep Apnea in US Veterans

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