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Cerebral hemodynamics in patients with obstructive sleep apnea syndrome monitored with near-infrared spectroscopy (NIRS) during positive airways pressure (CPAP) therapy: a pilot study
Author(s): Zhongxing Zhang; Maja Schneider; Marco Laures; Ursula Fritschi; Isabella Lehner; Ming Qi; Ramin Khatami
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Paper Abstract

In obstructive sleep apnea syndrome (OSA) the periodic reduction or cessation of breathing due to narrowing or occlusion of the upper airway during sleep leads to daytime symptoms and increased cardiovascular risk, including stroke. The higher risk of stroke is related to the impairment in cerebral vascular autoregulation. Continuous positive airways pressure (CPAP) therapy at night is the most effective treatment for OSA. However, there is no suitable bedside monitoring method evaluating the treatment efficacy of CPAP therapy, especially to monitor the recovery of cerebral hemodynamics. NIRS is ideally suited for non-invasive monitoring the cerebral hemodynamics during sleep. In this study, we will for first time assess dynamic changes of cerebral hemodynamics during nocturnal CPAP therapy in 3 patients with OSA using NIRS. We found periodic oscillations in HbO2, HHb, tissue oxygenation index (TOI) and blood volume associated with periodic apnea events without CPAP in all OSA patients. These oscillations were gradually attenuated and finally eliminated with the stepwise increments of CPAP pressures. The oscillations were totally eliminated in blood volume earlier than in other hemodynamic parameters. These results suggested that 1) the cerebral hemodynamic oscillations induced by OSA events can effectively be attenuated by CPAP therapy, and 2) blood flow and blood volume recovered first during CPAP therapy, followed by the recovery of oxygen consumption. Our study suggested that NIRS is a useful tool to evaluate the efficacy of CPAP therapy in patients with OSA bedside and in real time.

Paper Details

Date Published: 5 March 2014
PDF: 7 pages
Proc. SPIE 8928, Optical Techniques in Neurosurgery, Neurophotonics, and Optogenetics, 89281Z (5 March 2014); doi: 10.1117/12.2036263
Show Author Affiliations
Zhongxing Zhang, Clinic Barmelweid (Switzerland)
Univ. Hospital Zurich (Switzerland)
Maja Schneider, Clinic Barmelweid (Switzerland)
Univ. Hospital Zurich (Switzerland)
Marco Laures, Clinic Barmelweid (Switzerland)
Ursula Fritschi, Clinic Barmelweid (Switzerland)
Isabella Lehner, Clinic Barmelweid (Switzerland)
Ming Qi, Clinic Barmelweid (Switzerland)
Ramin Khatami, Clinic Barmelweid (Switzerland)
Univ. Hospital Zurich (Switzerland)

Published in SPIE Proceedings Vol. 8928:
Optical Techniques in Neurosurgery, Neurophotonics, and Optogenetics
Henry Hirschberg M.D.; E. Duco Jansen; Samarendra K. Mohanty; Nitish V. Thakor; Qingming Luo; Steen J. Madsen, Editor(s)

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