Compression Stockings May Reduce Incidence of OSA

[feeling_better]

This is a very interesting finding! Almost anybody can experiment with to see if it has any beneficial effect, and the compression stockings can be improvised with many inexpensive items, such as compression elastic bandages.

Perhasps we should do a poll here of those who try this, what if any, AHI reduction they may experience while still on cpap.

feeling_better


Compression Stockings May Reduce Incidence of OSA
Emma Hitt, PhD

August 8, 2011 — Compression stockings may decrease the incidence of obstructive sleep apnea (OSA) in patients with chronic venous insufficiency, reducing nightly episodes by more than a third compared with a control period with no stockings, according to the findings of a new study.

Stefania Redolfi, MD, with the Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Sleep Disorders Unit, in Paris, France, and colleagues reported the findings online August 4 in the American Journal of Respiratory and Critical Care Medicine.

"In previous studies, we showed that the apnea-hypopnea index is strongly linked to the volume of fluid shifting from the legs into the neck overnight, suggesting that such a mechanism plays a pathophysiological role in OSA," the study authors write.

In the current study, the researchers found that in nonobese participants with OSA and venous insufficiency, "wearing compression stockings during the day attenuates OSA by reducing fluid accumulation in the legs and its overnight redistribution into the neck. Reducing overnight rostral fluid displacement is therefore a new means of attenuating OSA," they write.

The study included 12 participants who were randomly assigned to 1 week of wearing compression stockings or to a 1-week control period without compression stockings. At that time, they crossed over to the other group. Overnight changes in leg fluid volume and neck circumference were measured at baseline and at the end of the compression stocking period and the control period.

Obstructive apneas were defined as cessation of airflow, and hypopnea was defined as at least a 50% reduction in airflow from baseline but remaining above zero for at least 10 seconds. The definition of hypopnea also required an out-of-phase thoracoabdominal motion or flow limitation on the nasal pressure tracing associated with either an oxygen desaturation of more than 3% or an arousal.

Compared with the control period, at the end of the week-long compression stocking period, the overnight leg fluid volume was reduced by 62% (P = .001), and increase in overnight neck circumference was reduced by 60% (P = .001). In addition, the number of apneas and hypopnea per hour of sleep was reduced by 36% (P = .002).

"This double cross-over randomized study sheds light on the relationship between overnight displacement of fluid from the legs into the neck and OSA," the study authors conclude. "This provides proof-of-principle that reducing overnight rostral fluid displacement is a new means of attenuating OSA," they add. Other interventions that might be tested include diuretics and exercise.

The study was not commercially funded. The study authors have disclosed no relevant financial relationships.

Am J Resp Crit Care Med. Published online August 4, 2011.

[Uncle_Bob]

Interesting. I've just has ultrasound guided sclerotherapy treatment for varicose veins and need to be in compresssion stockings for another 2 months.

My first question would be what grade stocking did they use for the study?
mine are rated at 20-30 and they are thigh high and not just over the knee stockings.

I have not noticed any difference in my data while wearing them yet.

[mayondair]

There's been a little discussion of this in some other threads. Interesting, I'm wearing compression stockings now while waiting for a laser ablation in sept.currently using 20-30 stockings, knee or thigh high, I'm not 100% compliant . will be using 30- 40 thigh high for 3- 4 weeks after the ablation, I'll report back on any changes in AHI or pressure needs, currently using an auto at 11-15. Guess I'll measure my neck also

[Kiralynx]

There are therapeutic exercises which can help get the excess fluid out of the feet before bedtime.

I developed lymphedema after my 2008 cancer surgery, in which a number of the lymph nodes were removed, thus impairing the circulation.

I was taught by a therapist how to do these exercises, interestingly, AFTER my apnea diagnosis, but it does make for more comfortable sleep.

[PST]

There are therapeutic exercises which can help get the excess fluid out of the feet before bedtime.

I developed lymphedema after my 2008 cancer surgery, in which a number of the lymph nodes were removed, thus impairing the circulation.

I was taught by a therapist how to do these exercises, interestingly, AFTER my apnea diagnosis, but it does make for more comfortable sleep.

If I understand what the article is saying, exercises ought to make apnea worse, not better. The claim seems to be that at night, when our feet are level with our heads, fluid that has accumulated in the feet and legs due to edema redistributes itself throughout our bodies, including the neck, helping to restrict breathing. That sounds weird and unlikely to me, but exercises that helped move the fluid out before bedtime would just accelerate the process. The TED hose are supposed to prevent edema so there is no fluid to trickle up to our necks. I can't imagine that wearing them would help many people's sleep apnea.

[Goofproof]

Wearing them over your mask helps seal leaks. Jim

[mayondair]

The test subjects had vascular insufficiency, so probably compression stockings won't help many, ( compression stockings are not the same as TED stockings) . I do know that when I wear them I have less swelling of feet and legs. I'll be interested to see if I notice any difference with or without stockings and after surgery. When I shouldn't have vascular problems. I'm really not expecting my OSA to go away, only curious to see if there is any difference. kathy

[leonardlake]

I began using CPAP in 1999 and also had cancer surgery and radiation in 2003 for cancer in my leg. I developed lymphedema and must wear 30-40 thigh-high compression stockings during the day and a compression sleeve at night. I did have to increase my pressure from my original 7 to 9 cm H2O but I have not done any experimentation regarding changes in AHI when I haven't worn my compression sleeve since I have been almost 100% compliant with the lymphedema therapy.

I do use Rescan software so I might have to check my results next time I don't wear my sleeve one night.