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Nocturnal ischemic events in patients with obstructive sleep apnea syndrome and ischemic heart disease

Effects of continuous positive air pressure treatment

Nir Peled, MD^* , Edward G. Abinader, MD, Giora Pillar, MD, DSc^*, Dawood Sharif, MD and Peretz Lavie, PhD^*

^* Sleep Laboratory, Technion-Israel Institute of Technology, Haifa, Israel
Heart Institute, ‘Bnei-Zion’ Medical Center, Haifa, Israel

View larger version (16K): [in a new window]   Figure 1 Distribution of ischemic time across the sleep period (23:00 to 06:00) and during the first 2 h after awakening. This is based on data obtained from all patients who demonstrated ischemia; p < 0.06 one-way ANOVA. ANOVA = analysis of variance.

View larger version (95K): [in a new window]   Figure 2 (A) ST segment depression at the rebreathing phases of the apneas. This 5-min Holter recording depicts alternating ECG patterns of bradycardia-tachycardia typical of sleep apnea. Horizontal ST segment depressions of 1 mm were recorded at the tachycardia (rebreathing) phase. (B) An enlarged segment of a tachycardia phase, starting at approximately 01:58:30 clearly demonstrating the ST segment depression.

View larger version (19K): [in a new window]   Figure 3 Ischemic minutes before and during CPAP treatment (9 patients) (p < 0.01, paired t test). CPAP = continuous positive air pressure.