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

Abstract

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.

Effect of moderate alcohol upon obstructive sleep apnoea

“…kg BW -1 did not alter respiration during sleep. TESCHLER et al [14] suggested similar doses did not alter pressure requirements to maintain ventilation during sleep in patients with severe OSA.…”

“…kg BW -1 ), the effects upon apnoea severity are less clear. Some authors report an increase [9,12,27] and others no effect [13,14] upon severity of OSA. BERRY et al [10] reported 0.5 g alcohol .…”

“…dL -1 ). Similarly, TESCHLER et al [14] found no difference in the AHI (44±51 events . h -1 ) when males with severe OSA were given 0.5 g alcohol .…”

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

“…In contrast, Block et al (13) found no difference in the AHI (2.8 to 3.0 events/h) when subjects, with milder OSA, were given 1 g alcohol/kg BW (BAC 0.075 g/dl). Similarly, Teschler et al (14) found no difference in the AHI (44-51 events/h) when males with severe OSA were given 0.5 g alcohol/kg BW (BAC 0.05 g/dl). To further understand the effects of alcohol on sleepdisordered breathing, we undertook this study to determine the effects of moderate alcohol consumption on apnea-hypopnea frequency in healthy middle-aged male subjects.…”

Full polysomnography versus home sleep study: searching for the optimal procedure

“…Did he/she sleep on his back? Was the drug and alcohol level [15], degree of somnolence, and state of the nasal airway typical? Did he/she have bronchospasm?…”