Study: CPAP use may reverse negative changes in brain stem activity

A study shows that treating sleep apnea with a CPAP may reverse brain stem activity. -JR

Sleep apnea treatment may reverse changes in brain stem activity associated with increased risk of heart disease, a new study suggests.

The findings "highlight the effectiveness of CPAP treatment in reducing one of the most significant health issues [heart disease] associated with obstructive sleep apnea," the researchers concluded. CPAP stands for continuous positive airway pressure.

Previous research suggests that people with obstructive sleep apnea have greater activity in nerves associated with stress response, which can lead to high blood pressure and heart problems. This increased nerve activity is due to altered brain stem function caused by sleep apnea, earlier studies have shown.

In this small study, published recently in the Journal of Neurophysiology, Australian researchers found that CPAP treatment reduced that nerve activity by restoring normal brain stem function.

The study included 13 sleep apnea patients who were assessed before and after six months of CPAP treatment.

"These data strongly suggest that functional and anatomical changes within the brain stem, which we believe underlie the elevated sympathetic activity in individuals with untreated obstructive sleep apnea, can be restored to healthy levels by CPAP treatment," the University of Sydney researchers wrote.

In obstructive sleep apnea, muscles in the airway collapse during sleep and block breathing. A CPAP device keeps airways open by delivering a steady flow of air while patients sleep.

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CPAP adherence improved by family support

Family support may improve a person's adherence to CPAP treatment for sleep apnea.

A new study suggests that people with obstructive sleep apnea (OSA) who are single or have unsupportive family relationships may be less likely to adhere to continuous positive airway pressure (CPAP) therapy.

Results show that individuals who were married or living with a partner had better CPAP adherence after the first three months of treatment than individuals who were single. Higher ratings of family relationship quality also were associated with better adherence. Results were adjusted for potential confounding factors including age, gender and body mass index.

"This is the first study to explore the role of family factors in CPAP adherence," said lead author Faith Luyster, PhD, research assistant professor in the School of Nursing at the University of Pittsburgh. "Having healthy relationships with family members can create an environment that supports the patient's use of CPAP."

The research abstract was published recently in an online supplement of the journal Sleep and will be presented Monday, June 2, in Minneapolis, Minnesota, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies LLC.

The study group comprised 253 patients with OSA who were participating in a CPAP adherence intervention trial. Relationship status at baseline was identified, and family relationship quality was assessed using the 12-item General Functioning subscale of the Family Assessment Device. Treatment adherence was measured objectively, and was defined as average hours of CPAP use per night during a three month follow-up period.

According to Luyster, the results provide a potential target for interventions to improve CPAP adherence.

"Family-based CPAP adherence interventions may help patients who would benefit from family support during the initial treatment period," she said.

The American Academy of Sleep Medicine reports that obstructive sleep apnea is a common sleep illness affecting up to seven percent of men and five percent of women. It involves repetitive episodes of complete or partial upper airway obstruction occurring during sleep despite an ongoing effort to breathe. The most effective treatment option for OSA is CPAP therapy, which helps to keep the airway open by providing a stream of air through a mask that is worn during sleep.

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