Wearing Compression Stockings Helps Reducing Obstructive Sleep Apnea

Sunday, August 7th, 2011 at 12:24 PM

Wearing compression stockings could be an effective and cheap way to help people suffering with a common sleep disorder, scientists say.

Researchers from the University of Brescia in Italy, found that wearing flight socks during the day reduced the symptoms of sleep apnea among sufferers at night.

Around four per cent of men and two per cent of women in the UK have the condition that interrupts breathing at night for ten seconds at a time.It can leave sufferers feeling exhausted as the body reacts to obstructed airways by going from a state of deep sleep to lighter rest.There are few effective treatments available for the condition, which is particularly prevalent among the overweight and over-65s. Many refuse to use available airway machines as they require wearing a mask all night.

Study leader Dr Stefania Redolfi, said: ‘We found that in patients with chronic venous insufficiency, compression stockings reduced daytime fluid accumulation in the legs, which in turn reduced the amount of fluid flowing into the neck at night, thereby reducing the number of apneas and hypopnea by more than a third.’

Continuous positive airway pressure machines, known as CPAP, are one of the only treatment options currently recommended for people with OSA. However, compliance is low, resulting in many patients living with untreated obstructive sleep apnea (OSA) and its serious health consequences including high blood pressure and depression.

Dr Redolfi and colleagues sought to determine whether a simple intervention like wearing compression stockings might be effective.In active people, fluid accumulation in the legs is counteracted by leg muscle contractions that squeeze the veins. However, prolonged sitting can prevent this process, and the accumulated fluid in the legs then shifts rostrally overnight.

This shift results in fluid accumulation in neck tissue and is thought to increase apneic events by increasing the volume of the tissue, leading to repetitive collapse of the pharynx during night breathing.

In otherwise healthy subjects who have heart failure or hypertension, the amount of this overnight rostral fluid shift is strongly correlated with the degree of overnight increase in neck circumference and the number of apneas and hypopnea per hour of sleep.

To investigate whether compression stockings could alleviate this problem, the researchers recruited subjects from the chronic venous insufficiency clinic at La Pitié-Salpêtrière hospital in Paris.Twelve patients were randomly assigned to one week of wearing the compression stockings or to a one-week control period without them.

Overnight changes in leg fluid volume and neck circumference were measured at the start and ends of the week.The team found the subjects who wore flight socks had an average of a 62 percent reduction in overnight leg fluid volume change as compared to when they did not wear the stockings.

Patients also had a 60 per cent reduction in neck circumference increase, which the researchers used as a proxy measurement to estimate fluid shift into the neck and a 36 per cent reduction in the number of apnoeas and hypopnea per hour of sleep.

Dr Redolfi said: ‘These findings are what we expected,’ she continued, ‘but the extent to which simply wearing compression stockings reduced apnea in just one week was not expected.‘It would be very interesting to see whether the wearing of the stockings over longer periods would have an even greater effect.‘