EFFECTS OF TRANSIENT AND PERSISTENT CEREBROSPINAL-FLUID DRAINAGE ON SLEEP-DISORDERED BREATHING IN PATIENTS WITH IDIOPATHIC ADULT HYDROCEPHALUS SYNDROME

Objectives-To examine sleep disordered breathing including obstructive sleep apnoea in patients with idiopathic adult hydrocephalus syndrome (IAHS) and to study the effects of CSF drainage and shunting procedur e on sleep disordered breathing. Methods-In 17 patients with IAHS poly somnographic investigations were performed before and after lumbar CSF drainage and after shunt operation. Results-Baseline investigations d ocumented a high prevalence of sleep related obstructive respiratory e vents (respiratory disturbance index >10 in 65% of the patients) and i mpaired sleep structure. There was no correlation between respiratory disturbance index and CSF pressure. Minimum oxygen saturation was high ly correlated with cognitive function. Neither lumbar CSF drainage nor shunting alleviated the respiratory disturbance index. REM and delta sleep increased initially after shunting but there was no sustained ef fect on sleep quality. Conclusions-Sleep disordered breathing is a pre valent finding in patients with IAHS. The shortcoming of CSF drainage to improve sleep disordered breathing either transiently or permanentl y implies that sleep disordered breathing is a coexistent condition, o r an irreversible consequence of the hydrocephalus, with a potential o f causing additional dysfunction in IAHS.