ACUTE WITHDRAWAL OF NASAL CPAP IN OBSTRUCTIVE SLEEP-APNEA DOES NOT CAUSE A RISE IN STRESS HORMONES

We hypothesized that withdrawal of nasal continuous positive airway pr essure (CPAP) in patients with sleep apnea would produce a measurable stress response. To test this hypothesis, we ceased CPAP in eight pati ents regularly using nasal CPAP long term and measured the effect on s leep apnea as well as plasma and urinary levels of the stress hormones , noradrenaline, cortisol and adrenocorticotropic hormone (ACTH). CPAP withdrawal led to an immediate recurrence of sleep apnea with increas es in apnea index, arousal index and oxygen desaturation (all p <.0001 ) but no change in levels of noradrenaline, cortisol or ACTH. We concl ude that acute withdrawal of CPAP in patients with sleep apnea does no t lead to a classic stress response.