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CPAP in OSA Linked to Beneficial Activity in Brain Stem

In small study, continuous positive airway pressure linked with restored sympathetic drive

WEDNESDAY, Sept. 23, 2015 (HealthDay News) -- Continuous positive airway pressure (CPAP) treatment can lead to brain stem activity changes associated with restored sympathetic drive in patients with obstructive sleep apnea (OSA), according to a small study published in the Aug. 1 issue of the Journal of Neurophysiology.

Linda C. Lundblad, Ph.D., of the School of Medicine at the University of Western Sydney, and colleagues gathered recordings of muscle sympathetic nerve activity (MSNA) and blood oxygen level-dependent (BOLD) signal intensity of the brain stem via high-resolution functional magnetic resonance imaging, in 15 controls and 13 subjects with OSA, before and after six months of CPAP treatment.

The investigators found that six months of CPAP treatment was associated with significantly reduced MSNA in subjects with OSA. MSNA-coupled changes in BOLD signal intensity within the dorsolateral pons, medullary raphe, and rostral ventrolateral medulla were also found to return to control levels.

"These data strongly suggest that functional and anatomical changes within the brain stem, which we believe underlie the elevated sympathetic activity in individuals with untreated OSA, can be restored to healthy levels by CPAP treatment," the authors write. "These data highlight the effectiveness of CPAP treatment in reducing one of the most significant health issues associated with OSA, that is, elevated MSNA and its associated elevated morbidity."

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