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Propofol‐induced sleep: Polysomnographic evaluation of patients with obstructive sleep apnea and controls

2010; Wiley; Volume: 142; Issue: 2 Linguagem: Inglês

10.1016/j.otohns.2009.11.002

1097-6817

Fábio Augusto Winckler Rabelo, Adriano H. Braga, Daniel S. Küpper, José Antônio Apparecido de Oliveira, Fernando Lopes, Pedro Luiz Vaz de Lima Mattos, Shirley G. Barreto, Heidi H. Sander, Regina M.F. Fernandes, Fabiana Cardoso Pereira Valera,

Sleep and Wakefulness Research

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. Study Design Prospective study of subjects submitted to polysomnography under sedation with propofol. Setting Tertiary referral center. Subjects and 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.