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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Study: Those with ongoing central pain may be linked to ADHD

A study indicates that those with central pain could also have ADHD.

More than a third of people with ongoing "central pain" may also have ADHD, a small study suggests.

Central pain stems from damage to the central nervous system -- the brain, brain stem and spinal cord. It differs from ongoing pain from bone or muscle conditions such as arthritis, or peripheral nerve pain like diabetic neuropathy.

Researcher Forest Tennant, MD, of Intractable Pain Management, presented the findings at the PAINWeek 2015 conference.

For the study, 45 people with chronic pain attending a treatment clinic completed a 16-item questionnaire. The questions asked whether the person had trouble with concentration, attention, distractibility, impulsivity, reading and retention, coordination, temper, and short-term memory.

A positive answer to five or more questions was considered to indicate ADHD

Results showed that 37.8% of the people met these criteria for the disorder.

Most people with centralized pain have an overactive autonomic nervous system, the part of the nervous system responsible for functions like breathing. This contributes to the ADHD (which is sometimes called ADD, or attention deficit disorder).

The finding might help explain why some people with pain have trouble with activities in their daily lives, Tennant says.

"For years, I've seen the same kind of ADD in these patients that you see in children -- they can't remember half the time, they can't concentrate," he says. "It's amazing how many of these patients actually quit reading or doing things, but they won't tell you."

But once they start taking medication for ADHD, "their pain gets better and they can remember and concentrate."

Tennant stressed that the findings [do not apply to] those with arthritis or neuropathic pain.

Jack LeFrock, MD, a pain specialist at Above and Beyond Pain Management and Laser Center, says Tennant's finding "makes sense."

"I agree with him; I think he's right on," he says.

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