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 The benefits of the knee-high socks, however, failed to convince
sleep specialists that they’d hit on a new cure for obstructive
sleep apnea, which is a potentially serious condition.
In obstructive sleep apnea, breathing repeatedly stops and starts
during sleep because the airway becomes narrowed or blocked. The
condition affects 12 million Americans, raising their risk of high
blood pressure, heart attack, stroke, irregular heartbeat and
diabetes. It also raises their risk of being sleepy and fatigued
during the day, because they sleep poorly at night.
The gold-standard therapy for obstructive sleep apnea is a
continuous positive airway pressure, or CPAP, device.
In the new study, 22 patients with obstructive sleep apnea who wore
compression stockings during the day for two weeks saw their
frequency of apneas decrease by 27 percent, compared to 23 patients
who didn’t wear the stockings, Dr. T. Douglas Bradley and colleagues
report in Sleep Medicine.
The authors call the 27 percent reduction “modest.” They say it
reduced patients’ sleep apnea “from the severe to the moderate
range.”
They did not, however, see any improvements in patients’ daytime
alertness or sleepiness.
There are a number of reasons the airway may be blocked during
sleep. For example, the throat muscles and tongue may relax,
blocking the airway.
This new study points to another potential mechanism, Bradley told
Reuters Health. He believes fluid can move from the legs into the
neck, restrict the flow of oxygen and cause obstructive sleep apnea.
“Getting rid of excess fluid is one approach of treating sleep
apnea,” said Bradley, a sleep specialist and professor at the
University of Toronto.
Compression stockings, widely used to treat varicose veins and by
workers whose jobs keep them on their feet all day, exert pressure
on the legs and reduce fluid movement.
“This study highlights what we believe to be a new cause of sleep
apnea,” Bradley said. “This is further evidence that it really is a
mechanism that causes sleep apnea.”
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But sleep specialist Dr. Jafari Behrouz of the University of
California, Irvine, told Reuters Health he is not ready to prescribe
the knee-highs to his apnea patients.
“At this point, I do not recommend stockings to treat sleep apnea,”
said Behrouz, who was not involved with the current study.
The first thing he recommends for sleep apnea patients is that they
improve their sleep hygiene by eliminating sedatives and alcohol for
six hours before bedtime and by avoiding caffeine after lunch. He
also advises that overweight patients try to lose weight and
morbidly obese patients consider bariatric surgery.
He also recommends that patients use the gold-standard CPAP device
when they sleep.
Some patients have trouble using it or do not like using it. A
mouthpiece called a mandibular advancement device is an alternative
that holds the lower jaw and tongue forward during sleep.
Snorers, especially men 50 years and older with a history of high
blood pressure or stroke should talk to their doctors about their
risk for sleep apnea, Behrouz said.
“The patient and physician can discuss what’s the best treatment for
them,” he said. “For the majority of the patients, the best
treatment still is the CPAP machine.”
SOURCE: http://bit.ly/1CNgJvf Sleep Medicine, online December 18,
2014.
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