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Transient intracranial pressure elevations (B waves) are associated with sleep apnea
Casper Schwartz Riedel1,2, Isabel Martinez-Tejada3,4, Morten Andresen3
1Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Inge Lehmanns Vej 6, Copenhagen East, 2100, Copenhagen, Denmark. casper.schwartz.riedel@regionh.dk.
Fluids and Barriers of the CNS
|October 2, 2023
Summary
Sleep apnea is linked to transient intracranial pressure (ICP) elevations, like B-waves. Treating sleep apnea with CPAP can reduce these ICP events, suggesting its importance in ICP management.
Area of Science:
- Neurosurgery
- Sleep Medicine
- Neurology
Background:
- Repetitive transient intracranial pressure (ICP) elevations (B-waves) are critical diagnostic markers.
- Previous research linked nocturnal ICP elevations to sleep apnea in specific patient groups.
- The general association between ICP patterns and sleep apnea remained unclear.
Purpose of the Study:
- To investigate the association between transient ICP elevations and sleep apnea.
- To determine if sleep apnea contributes significantly to ICP macropatterns.
- To evaluate the effect of continuous positive airway pressure (CPAP) on ICP elevations.
Main Methods:
- 34 patients with hydrocephalus or idiopathic intracranial hypertension (IIH) underwent overnight ICP monitoring and polysomnography (PSG).
- Transient ICP elevations were quantified, and temporal delays from sleep apnea events were measured.
- Three patients received CPAP treatment for an additional night to assess its impact.
Main Results:
- All patients exhibited transient ICP elevations associated with sleep apnea, with a mean delay of 3.6 seconds.
- Ramp-type elevations correlated with REM sleep, while sinusoidal elevations correlated with NREM sleep.
- CPAP treatment reduced transient ICP elevations by 37% in treated patients.
Conclusions:
- Sleep apnea is a significant cause of transient ICP elevations, necessitating its consideration in ICP evaluation.
- CPAP treatment for sleep apnea can effectively decrease the frequency of transient ICP elevations.
- Further research is required on the influence of slow oscillating mechanisms on ICP during high ICP and REM sleep.
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