Effects of venous compression of the legs on overnight rostral fluid shift and obstructive sleep apnea
Abstract
The amount of fluid displaced overnight from the legs into the neck as a consequence of lying recumbent correlates with the number of apneas and hypopneas per hour of sleep (AHI). Sedentary living promotes dependent fluid accumulation in the legs that can be counteracted by venous compression of the legs (compression stockings). We hypothesized that, in non-obese sedentary men with obstructive sleep apnea (OSA), wearing compression stockings during daytime will reduce the AHI by reducing the amount of fluid available for the displacement into the neck overnight. Polysomnography and measurement of overnight changes in leg fluid volume and neck circumference were performed at baseline and after one day of legs venous compression. The median AHI decreased from 30.9 (interquartile range 19.6-60.4) to 23.4 (12.9-31.8) (P=0.016) in association with a median 40% reduction in the change in leg fluid volume (P=0.016) and a median 42% reduction in the increase in neck circumference (P=0.016). These results provide proof-of-principle that overnight fluid displacement into the neck plays a causative role in OSA.
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This central accumulation of fluid has been shown to contribute to upper airway edema with associated increases in upper airway resistance, thereby worsening obstructive sleep apnea.
“This central accumulation of fluid has been shown to contribute to upper airway edema with associated increases in upper airway resistance, thereby worsening OSA.284,285”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [285]
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Self-citationRelationship between Overnight Rostral Fluid Shift and Obstructive Sleep Apnea in Nonobese Men
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Self-citationFluid Shift by Lower Body Positive Pressure Increases Pharyngeal Resistance in Healthy Subjects
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Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153 · see citing works
Kasai, T., Bradley, T. D., Friedman, O., & Logan, A. G. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000047 · Cited by 127 · see citing works
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- Authors
- Redolfi, S., Arnulf, I., Pottier, M., Bradley, T. D., & Similowski, T.
- Affiliations
- Inserm (FR)
- University Health Network (CA)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Redolfi, Stefania
- Venue
- Respiratory Physiology & Neurobiology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 175
- Issue
- 3
- Pages
- 390-393
- ISSN
- 1569-9048 (ISSN-L)
- OpenAlex
- W2054156281
- Cited by
- 93
- References
- 11
- Citations by year
- 2026: 2 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 9 · 2017: 8 · 2016: 7 · 2015: 13 · 2014: 7 · 2013: 3 · 2012: 18
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Respiratory Physiology & Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- obstructive sleep apnea, compression stockings, venous compression, neck circumference, apnea-hypopnea index, sedentary lifestyle, recumbent posture, fluid accumulation
- MeSH terms
- Adult, Edema, Humans, Leg, Male, Middle Aged, Neck, Polysomnography, Fluid Shifts, Sleep Apnea, Obstructive, Body Size, Stockings, Compression
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