CPAP is Better
Treatment for OSA than AOP (Atrial Overdrive Pacing)
CPAP nasal mask
A comparison has been made between the standard CPAP therapy and a new
treatment called AOP. The research was published in the New England
Journal of Medicine (NEJM) on December 15th. The new findings indicated
that CPAP is still a better therapy than AOP for obstructive sleep apnea
Two years ago French physicians said AOP (atrial overdrive pacing) had
produced significant improvement with some people with OSA. The new
research compared results of 16 patients and found AOP had no
All 16 people in the Greek trial already had a pacemaker. The
pacemakers were programmed to produce 15 beats more per minute than
normal in half the group. The other half kept the pacemaker programmed
to the normal beats per minute, but used CPAP (Constant Positive Air
Pressure) therapy. After one month the groups switched therapies.
"During AOP, no significant changes were observed in any of the
respiratory variables measured," according to the researchers. The CPAP
group got substantial improvement in sleep quality. The improvements
were measured in two ways. The researchers looked at the sleep index
that shows the incidence of apnea events. They also interviewed the
patients about their daytime sleepiness.
An earlier study initially backed up the French study, but now casts
doubt on it. Doctors at Baylor College of Medicine initially studied 13
patients and found AOP therapy significantly helped two of them. Since
then they have enrolled more patients and “they did not respond”.
The AOP treatment could benefit patients with CSA (Central Sleep
Apnea). This is a condition where the brain forgets to breath.
Typically this happens to people as they age. The Greek research
concerned itself with people with OSA (obstructive sleep apnea). This
occurs when the airway is obstructed, usually because the throat relaxes
Sleep apnea increases the risk of stroke and heart attack. Sleep apnea
can also cause an increase in early morning blood pressure. Most people
do not realize they have sleep apnea because they are asleep when it
occurs. The first sign to look for is a loud snore.
Earlier research shows that
CPAP therapy can help prevent heart
failure. Research at UCLA found that
as we age we lose brain stem
cells. They found that this is the primary reason why the elderly
develop CSA. There is a timed CPAP therapy that is developed for CSA.
The Greek trial was conducted by doctors at Heraklion University
Hospital in Crete.
By Dan Wilson
Best Syndication Staff Writer
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