Spiesshoefer, Jens ORCID: 0000-0001-8205-1749, Bannwitz, Britta, Mohr, Michael, Herkenrath, Simon, Randerath, Winfried, Sciarrone, Paolo ORCID: 0000-0002-8803-4533, Thiedemann, Christian, Schneider, Hartmut, Braun, Andrew T., Emdin, Michele, Passino, Claudio, Dreher, Michael, Boentert, Matthias and Giannoni, Alberto . Effects of nasal high flow on sympathovagal balance, sleep, and sleep-related breathing in patients with precapillary pulmonary hypertension. Sleep Breath.. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1522-1709

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Abstract

Background In precapillary pulmonary hypertension (PH), nasal high flow therapy (NHF) may favorably alter sympathovagal balance (SVB) and sleep-related breathing through washout of anatomical dead space and alleviation of obstructive sleep apnea (OSA) due to generation of positive airway pressure. Objectives To investigate the effects of NHF on SVB, sleep, and OSA in patients with PH, and compare them with those of positive airway pressure therapy (PAP). Methods Twelve patients with PH (Nice class I or IV) and confirmed OSA underwent full polysomnography, and noninvasive monitoring of SVB parameters (spectral analysis of heart rate, diastolic blood pressure variability). Study nights were randomly split into four 2-h segments with no treatment, PAP, NHF 20 L/min, or NHF 50 L/min. In-depth SVB analysis was conducted on 10-min epochs during daytime and stable N2 sleep at nighttime. Results At daytime and compared with no treatment, NHF20 and NHF50 were associated with a flow-dependent increase in peripheral oxygen saturation but a shift in SVB towards increased sympathetic drive. At nighttime, NHF20 was associated with increased parasympathetic drive and improvements in sleep efficiency, but did not alter OSA severity. NHF50 was poorly tolerated. PAP therapy improved OSA but had heterogenous effects on SVB and neutral effects on sleep outcomes. Hemodynamic effects were neutral for all interventions. Conclusions In sleeping PH patients with OSA NHF20 but not NHF50 leads to decreased sympathetic drive likely due to washout of anatomical dead space. NHF was not effective in lowering the apnea-hypopnoea index and NHF50 was poorly tolerated.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Spiesshoefer, JensUNSPECIFIEDorcid.org/0000-0001-8205-1749UNSPECIFIED
Bannwitz, BrittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mohr, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herkenrath, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Randerath, WinfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sciarrone, PaoloUNSPECIFIEDorcid.org/0000-0002-8803-4533UNSPECIFIED
Thiedemann, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneider, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, Andrew T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Emdin, MicheleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Passino, ClaudioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dreher, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boentert, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Giannoni, AlbertoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-322814
DOI: 10.1007/s11325-020-02159-1
Journal or Publication Title: Sleep Breath.
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1522-1709
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SYMPATHETIC-NERVE ACTIVITY; POSITIVE AIRWAY PRESSURE; HEART-RATE-VARIABILITY; OXYGEN-THERAPY; EUROPEAN ASSOCIATION; PROGNOSTIC VALUE; BLOOD-PRESSURE; DEAD-SPACE; APNEA; CANNULAMultiple languages
Clinical Neurology; Respiratory SystemMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32281

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