Cerebral hemodynamic changes in sleep apnea syndrome and effect of continuous positive airway pressure treatment

M. Diomedi, F. Placidi, L. M. Cupini, G. Bernardi, Mauro Silvestrini

Research output: Contribution to journalArticle

137 Citations (Scopus)

Abstract

Background and Objective: A clear association among snoring, sleep apnea, and increased risk of stroke has been shown by previous studies. However, the possible role played by sleep apnea in the pathogenesis of cerebrovascular disease is subject to debate. To evaluate the influence of hemodynamic changes caused by obstructive sleep apnea syndrome (OSAS), we investigated cerebrovascular reactivity to hypercapnia in patients with OSAS. Methods: The study was performed at baseline and after 1 night and 1 month of nasal continuous positive airway pressure (n-CPAP) therapy, with patients in the waking state (8:00 to 8:30 AM and 5:30 to 6:00 PM) with transcranial Doppler ultrasonography. Cerebrovascular reactivity was calculated with the breath-holding index (BHI). Results: In the baseline condition, compared with normal subjects, patients with OSAS showed significantly lower BHI values in both the morning (0.57 versus 1.40, p <0.0001) and the afternoon (1.0 versus 1.51, p <0.0001). Cerebrovascular reactivity was significantly higher in the afternoon than it was in the morning in both patients (p <0.0001) and controls (p <0.05). In patients, the BHI returned to normal values, comparable with those of control subjects, after both 1 night and 1 month of n-CPAP therapy. Conclusions: These findings suggest an association between OSAS and diminished cerebral vasodilator reserve. This condition may be related to the increased susceptibility to cerebral ischemia in patients with OSAS, particularly evident in the early morning.

Original languageEnglish
Pages (from-to)1051-1056
Number of pages6
JournalNeurology
Volume51
Issue number4
Publication statusPublished - Oct 1998

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Continuous Positive Airway Pressure
Sleep Apnea Syndromes
Obstructive Sleep Apnea
Hemodynamics
Breath Holding
Therapeutics
Doppler Transcranial Ultrasonography
Cerebrovascular Disorders
Snoring
Hypercapnia
Brain Ischemia
Vasodilator Agents
Reference Values
Stroke

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Diomedi, M., Placidi, F., Cupini, L. M., Bernardi, G., & Silvestrini, M. (1998). Cerebral hemodynamic changes in sleep apnea syndrome and effect of continuous positive airway pressure treatment. Neurology, 51(4), 1051-1056.

Cerebral hemodynamic changes in sleep apnea syndrome and effect of continuous positive airway pressure treatment. / Diomedi, M.; Placidi, F.; Cupini, L. M.; Bernardi, G.; Silvestrini, Mauro.

In: Neurology, Vol. 51, No. 4, 10.1998, p. 1051-1056.

Research output: Contribution to journalArticle

Diomedi, M, Placidi, F, Cupini, LM, Bernardi, G & Silvestrini, M 1998, 'Cerebral hemodynamic changes in sleep apnea syndrome and effect of continuous positive airway pressure treatment', Neurology, vol. 51, no. 4, pp. 1051-1056.
Diomedi M, Placidi F, Cupini LM, Bernardi G, Silvestrini M. Cerebral hemodynamic changes in sleep apnea syndrome and effect of continuous positive airway pressure treatment. Neurology. 1998 Oct;51(4):1051-1056.
Diomedi, M. ; Placidi, F. ; Cupini, L. M. ; Bernardi, G. ; Silvestrini, Mauro. / Cerebral hemodynamic changes in sleep apnea syndrome and effect of continuous positive airway pressure treatment. In: Neurology. 1998 ; Vol. 51, No. 4. pp. 1051-1056.
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