PURPOSE: Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse during sleep, leading to decreased oxygen blood levels and arousal from sleep. The gold standard treatment option for moderate to severe OSA is considered continuous positive airway pressure (CPAP). In case primary treatment with CPAP fails, a reevaluation of disease severity [by means of the apnea/hypopnea-index (AHI)] can be required. A subset of patients that prefer a CPAP alternative is still using CPAP until the reevaluation polysomnography (PSG), and a so-called washout effect is not ruled out. The purpose of this study is to evaluate the evidence on the existence and duration of this washout effect and its clinical relevance for current practice. METHODS: To identify papers for this review, an extensive literature search was run electronically through MEDLINE and EMBASE databases. RESULTS: An overview of currently available literature on this washout effect and the findings of 13 studies on this topic are discussed. CONCLUSION: There is some evidence that CPAP washout exists in patients with a stable BMI throughout the follow-up period. However, the intensity and duration of this effect remains unclear. Within the limitations of the present study, it seems reasonable to maintain a washout period of 1 week, in case alternative treatments options are considered and especially when a baseline PSG (and subsequent repeat PSG after treatment) is needed in case of clinical trials.
PURPOSE: Obstructive sleep apnea (OSA) is characterized by repetitive upper airway collapse during sleep, leading to decreased oxygen blood levels and arousal from sleep. The gold standard treatment option for moderate to severe OSA is considered continuous positive airway pressure (CPAP). In case primary treatment with CPAP fails, a reevaluation of disease severity [by means of the apnea/hypopnea-index (AHI)] can be required. A subset of patients that prefer a CPAP alternative is still using CPAP until the reevaluation polysomnography (PSG), and a so-called washout effect is not ruled out. The purpose of this study is to evaluate the evidence on the existence and duration of this washout effect and its clinical relevance for current practice. METHODS: To identify papers for this review, an extensive literature search was run electronically through MEDLINE and EMBASE databases. RESULTS: An overview of currently available literature on this washout effect and the findings of 13 studies on this topic are discussed. CONCLUSION: There is some evidence that CPAP washout exists in patients with a stable BMI throughout the follow-up period. However, the intensity and duration of this effect remains unclear. Within the limitations of the present study, it seems reasonable to maintain a washout period of 1 week, in case alternative treatments options are considered and especially when a baseline PSG (and subsequent repeat PSG after treatment) is needed in case of clinical trials.
Authors: Kate Sutherland; Olivier M Vanderveken; Hiroko Tsuda; Marie Marklund; Frederic Gagnadoux; Clete A Kushida; Peter A Cistulli Journal: J Clin Sleep Med Date: 2014-02-15 Impact factor: 4.062
Authors: Martin Glos; Thomas Penzel; Christoph Schoebel; Georg-Reiner Nitzsche; Sandra Zimmermann; Christopher Rudolph; Alexander Blau; Gert Baumann; Paul-Georg Jost-Brinkmann; Stefanie Rautengarten; Jan Christian Meier; Ingrid Peroz; Ingo Fietze Journal: Sleep Breath Date: 2015-10-13 Impact factor: 2.816
Authors: Olivier M Vanderveken; Jolien Beyers; Sara Op de Beeck; Marijke Dieltjens; Marc Willemen; Johan A Verbraecken; Wilfried A De Backer; Paul H Van de Heyning Journal: Front Neurosci Date: 2017-09-21 Impact factor: 4.677
Authors: Thalijn L C Wolters; Sean H P P Roerink; Linda C A Drenthen; Jolanda H G M van Haren-Willems; Margaretha A E M Wagenmakers; Johannes W A Smit; Adrianus R M M Hermus; Romana T Netea-Maier Journal: J Clin Endocrinol Metab Date: 2020-01-01 Impact factor: 5.958