Factors predisposing to worsening of sleep apnea in response to fluid overload in men

Publication date: Available online 20 July 2016
Source:Sleep Medicine
Author(s): Bojan Gavrilovic, T. Douglas Bradley, Daniel Vena, Owen D Lyons, Joseph M Gabriel, Milos R Popovic, Azadeh Yadollahi
ObjectivesObstructive sleep apnea (OSA) is highly prevalent in patients with fluid retaining conditions. Using bioimpedance measurements, previous studies have shown that the greater the amount of fluid redistributing from the legs to the neck overnight, the greater the severity of OSA. Our objective was to investigate factors that predispose to the development or worsening of OSA in response to experimental fluid overload.MethodsFifteen normotensive and non-obese adult men with and without OSA underwent polysomnography (PSG) during which normal saline was infused intravenously at a minimal rate to keep the vein open (control) or as a bolus of 22ml/kg body weight (approximately 2L) in random order; and crossed-over after a week.Results and ConclusionsBefore and after sleep, neck circumference and bioimpedance were measured to calculate neck resistance; reactance, phase angle and fluid volume. Subjects who experienced more than a two-fold increase in AHI or OAHI from control to intervention and had an AHI>10 during intervention were considered susceptible to the development or worsening of OSA. Baseline neck circumference and phase angle before saline infusion were independently associated with increased susceptibility to developing or worsening OSA in response to saline infusion.In non-obese men, a larger neck circumference and bioimpedance phase angle of the neck, which may be associated with larger pharyngeal tissue content, is associated with increased susceptibility for worsening of OSA in response to fluid overloading.

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