Chest, Vol 95, 279-283, Copyright © 1989 by American College of Chest Physicians

ARTICLES

Intracranial pressure and obstructive sleep apnea

P Jennum and SE Borgesen
Department of Neurophysiology, Glostrup Hospital, Denmark.

In order to describe variation in AP and ICP during OSA, six patients with severe OSA were examined, with determination of ICP, AP, CVP, respiration, tcPO2, tcPCO2, and nocturnal sleep polygraphy. During apnea, elevations of AP and ICP were observed, related to the apneic episodes. The elevations in pressure were only observed in relation to apneic episodes. While awake, none of the patients showed pressure elevations. There were highly significant correlations between duration of apnea and variation in AP and ICP and between variations in AP and ICP. Values for ICP while awake were above normal (greater than 15 mm Hg; intracranial hypertension) in four of six patients. Morning ICP was higher than evening ICP. Systolic, mean, and diastolic ICP and AP increased during sleep above awake values. The ICP increased during NREM stages 1 to 4, and the highest values were observed during REM sleep. Vascular response was not changed during REM sleep, and the higher ICP during REM could solely be explained by the longer apneas during REM sleep. The CPP decreased during apnea.

This article has been cited by other articles:

				C. H. Won and C. Kirsch INTRACRANIAL HYPERTENSION CAUSED BY OBSTRUCTIVE SLEEP APNEA AND OBESITY HYPOVENTILATION SYNDROME Chest Meeting Abstracts, October 1, 2006; 130(4): 345S - 346S. [Abstract] [PDF]

				H. K. Yaggi, J. Concato, W. N. Kernan, J. H. Lichtman, L. M. Brass, and V. Mohsenin Obstructive Sleep Apnea as a Risk Factor for Stroke and Death. N. Engl. J. Med., November 10, 2005; 353(19): 2034 - 2041. [Abstract] [Full Text] [PDF]

				P M Turkington, V Allgar, J Bamford, P Wanklyn, and M W Elliott Effect of upper airway obstruction in acute stroke on functional outcome at 6 months Thorax, May 1, 2004; 59(5): 367 - 371. [Abstract] [Full Text] [PDF]

				P O Lundmark, G E Trope, and J G Flanagan The effect of simulated obstructive apnoea on intraocular pressure and pulsatile ocular blood flow in healthy young adults Br. J. Ophthalmol., November 1, 2003; 87(11): 1363 - 1369. [Abstract] [Full Text] [PDF]

				R. A. Dart, J. R. Gregoire, D. D. Gutterman, and S. H. Woolf The Association of Hypertension and Secondary Cardiovascular Disease With Sleep-Disordered Breathing Chest, January 1, 2003; 123(1): 244 - 260. [Abstract] [Full Text] [PDF]

				D. S.C. Hui, D. K.L. Choy, L. K.S. Wong, F. W.S. Ko, T. S.T. Li, J. Woo, and R. Kay Prevalence of Sleep-Disordered Breathing and Continuous Positive Airway Pressure Compliance* : Results in Chinese Patients With First-Ever Ischemic Stroke Chest, September 1, 2002; 122(3): 852 - 860. [Abstract] [Full Text] [PDF]

				V. Mohsenin and A. Culebras Sleep-Related Breathing Disorders and Risk of Stroke Editorial Comment : Balancing Sleep and Breathing Stroke, June 1, 2001; 32(6): 1271 - 1278. [Abstract] [Full Text] [PDF]

				J. A. Loadsman and D. R. Hillman Anaesthesia and sleep apnoea Br. J. Anaesth., February 1, 2001; 86(2): 254 - 266. [Abstract] [Full Text] [PDF]

				M. S. M. IP, B. LAM, L.-Y. CHAN, L. ZHENG, K. W. T. TSANG, P. C. W. FUNG, and W.-K. LAM Circulating Nitric Oxide Is Suppressed in Obstructive Sleep Apnea and Is Reversed by Nasal Continuous Positive Airway Pressure Am. J. Respir. Crit. Care Med., December 1, 2000; 162(6): 2166 - 2171. [Abstract] [Full Text]

				J. A. Loadsman and I. Wilcox Is obstructive sleep apnoea a rapid eye movement-predominant phenomenon? Br. J. Anaesth., September 1, 2000; 85(3): 354 - 358. [Abstract] [Full Text] [PDF]

				W. D. Leslie, S. Wali, M. Kryger, N. C. Netzer, and K. P. Strohl Blood Flow of the Middle Cerebral Artery With Sleep-Disordered Breathing: Correlation With Obstructive Hypopneas • Response Stroke, January 1, 1999; 30 (1): 188 - 190. [Full Text] [PDF]

				B. Kristensen, J. Malm, and T. Rabben Effects of transient and persistent cerebrospinal fluid drainage on sleep disordered breathing in patients with idiopathic adult hydrocephalus syndrome J. Neurol. Neurosurg. Psychiatry, October 1, 1998; 65(4): 497 - 501. [Abstract] [Full Text]

				M.R. Pressman, W.R. Schetman, W.G. Figueroa, B. Van Uitert, H.J. Caplan, and D.D. Peterson Transient Ischemic Attacks and Minor Stroke During Sleep : Relationship to Obstructive Sleep Apnea Syndrome Stroke, December 1, 1995; 26(12): 2361 - 2365. [Abstract] [Full Text]