Issue 27 – Insomnia as an expression pattern of obstructive sleep apnea – effect of nighttime ventilation therapy
Obstructive sleep apnea and insomnia often occur at the same time, and estimated that nearly half of patients with insomnia have symptoms of sleep apnea. In fact, these patients do not have other causes of insomnia, showing signs of obstructive sleep apnea.
The purpose of this medical study is to assess the therapeutic effect of nighttime ventilation on insomnia caused by obstructive sleep apnea.
In order to conduct this study, the authors examined medical records of patients with insomnia and sleep apnea who had undergone nighttime ventilation and excluded patients with mood disorders, sleep disorders, psychomotor and insomnia, circadian rhythm disorders, sleep disorders, inappropriate sleep hygiene, And abuse of hypnotic drugs, stimulants, antidepressants, anxiolytics and alcohol. For those patients who were selected, the study group analyzed their pre-and post-night effects, symptoms of insomnia, sleep apnea index (AHI), self-test method (ESS) scores and total sleep time.
Of the 1241 medical records, 56 patients with an average age of 60.9 ± 10 were selected. Among them, 22 were insomnia (39.3%), 19 were insomnia (33.9%), 8 were mixed insomnia (14.3%) and 7 were terminal insomnia (12.5%). 48 patients (85.7%) in the majority of patients had autoregulation ventilator treatment (APAP). Of these, 44 had resolved insomnia (78.6%); nine had symptoms of insomnia (16.1%) and three had quit treatment (5.4%). Insomnia category and can be treated are closely related, 75% of mixed insomnia patients failed to lift the symptoms of insomnia. There was a significant difference between patients who were able to solve the problem of insomnia and those who failed to improve, for the average transition time from receiving nocturnal respiratory therapy to receiving continuous treatment (more than 4 hours of treatment per night) Need 161 ± 61 days; the latter need 225 ± 141 days. Patients had an average of 5.29 ± 1.37 hours of sleep and 6.37 ± 1.55 hours of sleep per night before and after nighttime ventilation. Among those who had resolved insomnia, 6 had failed to meet the treatment criteria: 5 received more than 4 hours (60.6 ± 3.2%) of treatment during less than 70% of the treatment period, and 1 who received less treatment during the entire treatment At 4 hours (average 3.5 hours per night).
The efficacy of night-time ventilation therapy has been shown to be effective for insomnia, in addition to obstructive sleep apnea, even if the patient fails to follow the criteria. The results of this study reveal that, in addition to mixed insomnia patients, all symptoms of insomnia have the opportunity to be derived from obstructive sleep apnea.
Reference
Mendes Ms, Dos Santos Jm, Insomnia as an expression of obstructive sleep apnea syndrome – the effect of treatment with nocturnal ventilatory support, Rev Port Pneumol (2006). 2015 Feb 11. pii: S2173-5115(15)00014-7. doi: 10.1016/j.rppnen.2014.11.002.