title: Attenuation of obstructive sleep apnea by compression stockings in subjects with venous insufficiency.
abstract: BACKGROUND
  Fluid accumulation in the legs and its overnight redistribution into the neck appears to play a causative role in obstructive sleep apnea (OSA) in sedentary men. Chronic venous insufficiency (CVI) promotes fluid accumulation in the legs that can be counteracted by compression stockings.
  
  
  OBJECTIVE
  To test the hypotheses that, in nonobese subjects with CVI and OSA, wearing compression stockings during the day will attenuate OSA by reducing the amount of fluid displaced into the neck overnight.
  
  
  METHODS
  Nonobese subjects with CVI and OSA were randomly assigned to 1 week of wearing compression stockings or to a 1-week control period without compression stockings, after which they crossed over to the other arm. Polysomnography and measurement of overnight changes in leg fluid volume and neck circumference were performed at baseline and at the end of compression stockings and control periods.
  
  
  RESULTS
  Twelve subjects participated. Compared with the end of the control period, at the end of the compression stockings period there was a 62% reduction in the overnight leg fluid volume change (P = 0.001) and a 60% reduction in the overnight neck circumference increase (P = 0.001) in association with a 36% reduction in the number of apneas and hypopneas per hour of sleep (from 48.4 ± 26.9 to 31.3 ± 20.2, P = 0.002).
  
  
  CONCLUSIONS
  Redistribution of fluid from the legs into the neck at night contributes to the pathogenesis of OSA in subjects with CVI. Prevention of fluid accumulation in the legs during the day, and its nocturnal displacement into the neck, attenuates OSA in such subjects.
authors.affiliation: Inserm U-CRICM, Sleep Disorders Unit, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. redstefi@inwind.it
authors.forename: Stefania
authors.initials: S
authors.lastname: Redolfi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
authors.forename: Michel
authors.initials: M
authors.lastname: Pottier
authors.forename: Jacques
authors.initials: J
authors.lastname: Lajou
authors.forename: Isabelle
authors.initials: I
authors.lastname: Koskas
authors.forename: T Douglas
authors.initials: TD
authors.lastname: Bradley
authors.forename: Thomas
authors.initials: T
authors.lastname: Similowski
mesh_terms: D000465:Algorithms; D018592:Cross-Over Studies; D005260:Female; D018495:Fluid Shifts; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000503:physiopathology; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control*; D053828:Stockings, Compression; D016683:Supine Position; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*