Propofol-induced sleep: polysomnographic evaluation of patients with obstructive sleep apnea and controls.
OBJECTIVE
The localization of upper airway obstruction in patients with obstructive sleep apnea (OSA) may optimize treatment. Nasoendoscopy during propofol sedation allows such an evaluation, but the effect of this drug on respiratory patterns and muscle relaxation is unknown. The objective of the present study was to determine through polysomnography whether propofol would change sleep parameters.


METHODS
Prospective study of subjects submitted to polysomnography under sedation with propofol.


METHODS
Tertiary referral center.


METHODS
Fifteen non-obese subjects (4 controls/11 OSA patients) were submitted to two diurnal polysomnograms (90-120 minutes of sleep), with and without the use of propofol. The parameters presence of snoring, apnea-hypopnea index (AHI), oxygen desaturation, and sleep architecture were compared.


RESULTS
The use of propofol did not induce snoring in the control subjects, whereas 100 percent of the OSA patients snored. AHI and mean oxygen saturation (SaO(2)) did not differ significantly between examinations with and without sedation. However, minimum SaO(2) differed significantly (P < 0.05) with sedation, being lower during propofol sedation. Propofol also significantly changed the sleep architecture, with a significant increase in N3 sleep (P < 0.005) and total abolishment of rapid eye movement sleep (P < 0.0005) during propofol sedation.


CONCLUSIONS
These preliminary results allow us to infer that sedation with propofol changes sleep architecture but permits respiratory evaluation, because the main respiratory parameters evaluated in OSA are maintained. These preliminary results support the view that nasoendoscopy under propofol sedation is a promising examination for management of this disease.
Rabelo
Fábio A W
FA
Discipline of Otorhinolaryngology, University of São Paulo, São Paulo, Brazil. fawrabelo@hotmail.com
Braga
Adriano
A
Küpper
Daniel S
DS
De Oliveira
José A A
JA
Lopes
Fernando M
FM
de Lima Mattos
Pedro Luiz Vaz
PL
Barreto
Shirley G
SG
Sander
Heidi H
HH
Fernandes
Regina M F
RM
Valera
Fabiana C P
FC
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000032:analysis; D017286:Polysomnography; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D012913:Snoring / Q000503:physiopathology
D006993:Hypnotics and Sedatives; D010100:Oxygen; D015742:Propofol