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Silva BC, Santos RSS, Drager LF, et al. Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis. Front Med (Lausanne). 2017;4:57doi: 10.3389/fmed.2017.00057.
Silva, B. C., Santos, R. S. S., Drager, L. F., Coelho, F. M., & Elias, R. M. (2017). Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis. Frontiers in medicine, 457. https://doi.org/10.3389/fmed.2017.00057
Silva, Bruno C, et al. "Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis." Frontiers in medicine vol. 4 (2017): 57. doi: https://doi.org/10.3389/fmed.2017.00057
Silva BC, Santos RSS, Drager LF, Coelho FM, Elias RM. Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis. Front Med (Lausanne). 2017 May 19;4:57. doi: 10.3389/fmed.2017.00057. eCollection 2017. PMID: 28580357; PMCID: PMC5437164.
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Front Med (Lausanne). 2017 May 19;4:57. doi: 10.3389/fmed.2017.00057. eCollection 2017.

Impact of Compression Stockings vs. Continuous Positive Airway Pressure on Overnight Fluid Shift and Obstructive Sleep Apnea among Patients on Hemodialysis.

Frontiers in medicine

Bruno C Silva, Roberto S S Santos, Luciano F Drager, Fernando M Coelho, Rosilene M Elias

Affiliations

  1. Department of Medicine, Renal Division, Universidade de São Paulo, São Paulo, Brazil.
  2. Department of Medicine, Renal Division, Universidade Federal do Espírito Santo, Vitoria, Brazil.
  3. Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, Brazil.
  4. Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
  5. Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.

PMID: 28580357 PMCID: PMC5437164 DOI: 10.3389/fmed.2017.00057

Abstract

INTRODUCTION: Obstructive sleep apnea (OSA) is common in edematous states, notably in hemodialysis patients. In this population, overnight fluid shift can play an important role on the pathogenesis of OSA. The effect of compression stockings (CS) and continuous positive airway pressure (CPAP) on fluid shift is barely known. 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.

METHODS: Each participant performed polysomnography (PSG) at baseline, during CPAP titration, and after 1 week of wearing CS. Neck circumference (NC) and segmental bioelectrical impedance were done before and after PSG.

RESULTS: Fourteen patients were studied (53 ± 9 years; 57% men; body mass index 29.7 ± 6.8 kg/m

CONCLUSION: 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. CPAP improved OSA by exerting local pressure on upper airway, with no impact on fluid redistribution. CPAP performed significantly better than CS for both reduction of AHI and overnight reduction of NC. Complementary studies are needed to elucidate the mechanisms by which CPAP and CS reduce NC.

Keywords: compression stockings; continuous positive airway pressure; fluid shift; hemodialysis; obstructive sleep apnea

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