Laura H White1, Owen D Lyons1, Azadeh Yadollahi2, Clodagh M Ryan3, T Douglas Bradley4. 1. Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada; Centre for Sleep Medicine and Circadian Biology of the University of Toronto, Toronto, ON, Canada. 2. Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada; Institute of Biomaterial and Biomedical Engineering, University of Toronto, Toronto, ON, Canada. 3. Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada; Centre for Sleep Medicine and Circadian Biology of the University of Toronto, Toronto, ON, Canada; Department of Medicine of the University Health Network Toronto General Hospital, Toronto, ON, Canada. 4. Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada; Centre for Sleep Medicine and Circadian Biology of the University of Toronto, Toronto, ON, Canada; Department of Medicine of the University Health Network Toronto General Hospital, Toronto, ON, Canada. Electronic address: douglas.bradley@utoronto.ca.
Abstract
BACKGROUND: Overnight fluid shift from the legs to the neck may narrow the upper airway and contribute to obstructive sleep apnea (OSA) pathogenesis. We hypothesized that below-the-knee compression stockings will decrease OSA severity in a general OSA population by decreasing daytime leg fluid accumulation and overnight fluid shift and increasing upper-airway size. METHODS:Patients with OSA (apnea-hypopnea index ≥ 10) were randomized to wear compression stockings during the daytime or to a control group for 2 weeks. Overnight polysomnography with measurement of leg and neck fluid volumes and upper-airway cross-sectional area before and after sleep was performed at baseline and follow-up. The primary outcome was change in the apnea-hypopnea index. RESULTS: Twenty-two patients randomized to compression stockings and 23 to control completed the study. The apnea-hypopnea index decreased significantly more in the compression stockings than in the control group (from 32.4 ± 20.0 to 23.8 ± 15.5 vs. from 31.2 ± 25.0 to 30.3 ± 23.8, p = 0.042), in association with a significantly greater reduction in the overnight decrease in leg fluid volume (p = 0.028), and a significantly greater increase in morning upper-airway cross-sectional area (p = 0.006). Overnight change in neck fluid volume was unchanged. CONCLUSION: These observations suggest that in, a general OSA population, below-the-knee compression stockings decrease OSA severity modestly via attenuation of overnight fluid shift and consequent upper-airway dilatation.
RCT Entities:
BACKGROUND: Overnight fluid shift from the legs to the neck may narrow the upper airway and contribute to obstructive sleep apnea (OSA) pathogenesis. We hypothesized that below-the-knee compression stockings will decrease OSA severity in a general OSA population by decreasing daytime leg fluid accumulation and overnight fluid shift and increasing upper-airway size. METHODS:Patients with OSA (apnea-hypopnea index ≥ 10) were randomized to wear compression stockings during the daytime or to a control group for 2 weeks. Overnight polysomnography with measurement of leg and neck fluid volumes and upper-airway cross-sectional area before and after sleep was performed at baseline and follow-up. The primary outcome was change in the apnea-hypopnea index. RESULTS: Twenty-two patients randomized to compression stockings and 23 to control completed the study. The apnea-hypopnea index decreased significantly more in the compression stockings than in the control group (from 32.4 ± 20.0 to 23.8 ± 15.5 vs. from 31.2 ± 25.0 to 30.3 ± 23.8, p = 0.042), in association with a significantly greater reduction in the overnight decrease in leg fluid volume (p = 0.028), and a significantly greater increase in morning upper-airway cross-sectional area (p = 0.006). Overnight change in neck fluid volume was unchanged. CONCLUSION: These observations suggest that in, a general OSA population, below-the-knee compression stockings decrease OSA severity modestly via attenuation of overnight fluid shift and consequent upper-airway dilatation.
Authors: Swati A Bhatawadekar; Mark D Inman; Jeffrey J Fredberg; Susan M Tarlo; Owen D Lyons; Gabriel Keller; Azadeh Yadollahi Journal: J Appl Physiol (1985) Date: 2017-01-12
Authors: Xiaoshu Cao; Cristina de Oliveira Francisco; T Douglas Bradley; Nasim Montazeri Ghahjaverestan; Susan M Tarlo; Matthew B Stanbrook; Kenneth R Chapman; Mark Inman; Azadeh Yadollahi Journal: Nat Sci Sleep Date: 2022-05-06
Authors: Mehrnaz Shokrollahi; Frank Rudzicz; Daniel Vena; T Douglas Bradley; Azadeh Yadollahi Journal: Med Biol Eng Comput Date: 2017-07-05 Impact factor: 2.602
Authors: Swati A Bhatawadekar; Gabriel Keller; Cristina O Francisco; Mark D Inman; Jeffrey J Fredberg; Susan M Tarlo; Mathew Stanbrook; Owen D Lyons; Azadeh Yadollahi Journal: Front Physiol Date: 2017-12-12 Impact factor: 4.566