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Should i sleep in compression socks5/26/2023 ![]() ![]() Hypervolemia also augments overnight spontaneous fluid shift, which occurs as the fluid accumulated in the legs during the day moves rostrally during bedtime, while on recumbent position. It leads to edema formation in upper airways and, consequently, to pharyngeal narrowing ( 9, 10). Volume overload, which is commonly observed in these patients, plays a pivotal role in this context. Several factors contribute to the pathophysiology of OSA in patients with ESRD, such as uremia and associated comorbidities in ESRD ( 8). ![]() The prevalence of OSA among patients with end-stage renal disease (ESRD) varies according to the diagnostic criteria used and whether it was based on questionnaires (reaching 50–80%) ( 2, 3) or polysomnography (PSG) (16–46%) ( 4, 5) and is associated with mortality among patients on hemodialysis (HD) ( 6, 7). Obstructive sleep apnea (OSA) is a clinical condition characterized by recurrent episodes of partial or complete upper airway obstructions during sleep, promoting intermittent hypoxia and sleep fragmentation ( 1). Complementary studies are needed to elucidate the mechanisms by which CPAP and CS reduce NC. ![]() CPAP performed significantly better than CS for both reduction of AHI and overnight reduction of NC. CPAP improved OSA by exerting local pressure on upper airway, with no impact on fluid redistribution. CS, p = 0.01).Ĭonclusion: 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. 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. Overnight fluid shift at baseline, CPAP, and CS was −183 ± 72, −343 ± 220, and −290 ± 213 ml, respectively ( p = 0.006). CS reduced the fluid accumulated in lower limbs during the day, although not significantly. Nocturnal intracellular trunk water was higher after wearing CS in comparison to baseline and CPAP ( p = 0.03). Apnea–hypopnea index (AHI) decreased from 20.8 (14.2 39.6) at baseline to 7.9 (2.8 25.4) during CPAP titration and to 16.7 (3.5 28.9) events/h after wearing CS (CPAP vs. ![]() Results: Fourteen patients were studied (53 ± 9 years 57% men body mass index 29.7 ± 6.8 kg/m 2). Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG. Methods: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. 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. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. Introduction: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. 5Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.4Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.3Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil.2Department of Medicine, Renal Division, Universidade Federal do Espírito Santo, Vitoria, Brazil.1Department of Medicine, Renal Division, Universidade de São Paulo, São Paulo, Brazil. ![]()
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