Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis

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dc.citation.volume4
dc.contributor.authorSilva, Bruno C.
dc.contributor.authorSantos, Roberto S. S.
dc.contributor.authorDrager, Luciano F.
dc.contributor.authorCoelho, Fernando M. [UNIFESP]
dc.contributor.authorElias, Rosilene M.
dc.coverageLausanne
dc.date.accessioned2020-07-13T11:53:12Z
dc.date.available2020-07-13T11:53:12Z
dc.date.issued2017
dc.description.abstractIntroduction: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. We compared the effects of CS and CPAP on fluid dynamics in a sample of patients with OSA in hemodialysis, through a randomized crossover study. Methods: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG. Results: Fourteen patients were studied (53 9 yearsen
dc.description.abstract57% menen
dc.description.abstractbody mass index 29.7 6.8 kg/m(2)). Apnea hypopnea index (AHI) decreased from 20.8 (14.2en
dc.description.abstract39.6) at baseline to 7.9 (2.8en
dc.description.abstract25.4) during CPAP titration and to 16.7 (3.5en
dc.description.abstract28.9) events/h after wearing CS (CPAP vs. baseline, p = 0.004en
dc.description.abstractCS vs. baseline, p = 0.017en
dc.description.abstractand CPAP vs. CS, p = 0.017). Nocturnal intracellular trunk water was higher after wearing CS in comparison to baseline and CPAP (p = 0.03). CS reduced the fluid accumulated in lower limbs during the day, although not significantly. Overnight fluid shift at baseline, CPAP, and CS was -183 +/- 72, 343 +/- 220, and 290 +/- 213 ml, respectively (p = 0.006). Overnight NC increased at baseline (0.7 +/- 0.4 cm), decreased after CPAP (-1.0 +/- 0.4 cm), and while wearing CS (-0.4 +/- 0.8 cm) (CPAP vs. baseline, p < 0.0001en
dc.description.abstractCS vs. baseline, p = 0.001en
dc.description.abstractCPAP vs. CS, p = 0.01). Conclusion: CS reduced AHI by avoiding fluid retention in the legs, favoring accumulation of water in the intracellular component of the trunk, thus avoiding fluid shift to reach the neck. CPAP improved OSA by exerting local pressure on upper airway, with no impact on fluid redistribution. CPAP performed significantly better than CS for both reduction of AHI and overnight reduction of NC. Complementary studies are needed to elucidate the mechanisms by which CPAP and CS reduce NC.en
dc.description.affiliationUniv Sao Paulo, Dept Med, Renal Div, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Espirito Santo, Dept Med, Renal Div, Vitoria, Brazil
dc.description.affiliationUniv Sao Paulo, Inst Coracao InCor, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Psychobiol, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Neurol & Neurosurg, Sao Paulo, Bra
dc.description.sourceWeb of Science
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.3389/fmed.2017.00057
dc.identifier.citationFrontiers In Medicine. Lausanne, v. 4, p. -, 2017.
dc.identifier.doi10.3389/fmed.2017.00057
dc.identifier.fileWOS000407112200001.pdf
dc.identifier.issn2296-858X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54454
dc.identifier.wosWOS:000407112200001
dc.language.isoeng
dc.publisherFrontiers Media Sa
dc.relation.ispartofFrontiers In Medicine
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectobstructive sleep apneaen
dc.subjectcompression stockingsen
dc.subjectcontinuous positive airway pressureen
dc.subjectfluid shiften
dc.subjecthemodialysisen
dc.titleImpact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysisen
dc.typeinfo:eu-repo/semantics/article
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