Skip to main content Accessibility help
×
Home
Hostname: page-component-55597f9d44-dfw9g Total loading time: 0.331 Render date: 2022-08-19T11:26:31.749Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area

Published online by Cambridge University Press:  04 December 2013

Fumitaka Mito
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Tsuguo Nishijima*
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Shigeru Sakurai
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Tetsuya Kizawa
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Keisuke Hosokawa
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Susumu Takahashi
Affiliation:
Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Akira Suwabe
Affiliation:
Department of Laboratory Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Hiroshi Akasaka
Affiliation:
Department of Disaster Medicine, Iwate Medical University School of Medicine, Iwate, Japan
Sei-ichiro Kobayashi
Affiliation:
Department of Disaster Medicine, Iwate Medical University School of Medicine, Iwate, Japan
*
Correspondence: Tsuguo Nishijima, MD, PhD Division of Behavioral Sleep Medicine Iwate Medical University School of Medicine 19-1 Uchimaru Morioka City, Iwate Prefecture, Japan E-mail tsuguo@ck9.so-net.ne.jp

Abstract

Introduction

The 2011 Great East Japan Earthquake caused major disruptions in the provision of health care, including that for patients with sleep-disordered breathing (SDB) using a nasal continuous positive airway pressure (nCPAP) device. This study investigated the ability of SDB patients to continue using the nCPAP device in the weeks immediately following the earthquake, whether inability to use the nCPAP device led to symptom relapse, and measures that should be taken to prevent disruptions in nCPAP therapy during future disasters.

Hypothesis

If nCPAP devices cannot be used during disasters, SDB patients’ health will be affected negatively.

Methods

Within 14 days of the disaster, 1,047 SDB patients completed a questionnaire that collected data regarding ability to use, duration of inability to use, and reasons for inability to use the nCPAP device; symptom relapse while unable to use the nCPAP device; ability to use the nCPAP device use at evacuation sites; and recommendations for improvement of the nCPAP device.

Results

Of the 1,047 patients, 966 (92.3%) had been unable to use the nCPAP device in the days immediately following the earthquake. The most common reason for inability to use the nCPAP device was power failure, followed by anxiety about sleeping at night due to fear of aftershocks, involvement in disaster-relief activities, loss of the nasal CPAP device, and fear of being unable to wake up in case of an emergency. Among the 966 patients, 242 (25.1%) had experienced relapse of symptoms, the most common of which was excessive daytime sleepiness (EDS), followed by insomnia, headache, irritability, and chest pain.

Conclusion

Developing strategies for the continuation of nCPAP therapy during disasters is important for providing healthy sleeping environments for SDB patients in emergency situations.

MitoF, NishijimaT, SakuraiS, KizawaT, HosokawaK, TakahashiS, SuwabeA, AkasakaH, KobayashiS. Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area. Prehosp Disaster Med. 2013;28(6):547-555.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Young, T, Palta, M, Dempsey, J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-1235.CrossRefGoogle ScholarPubMed
2.Ancoli-Israel, S, Klauber, MR, Stepnowsky, C, Estline, E, Chinn, A, Fell, R. Sleep-disordered breathing in African-American elderly. Am J Respir Crit Care Med. 1995;152(6 Pt 1):1946-1949.CrossRefGoogle ScholarPubMed
3.Ip, MS, Lam, B, Tang, LC, et al. A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest. 2001;119(1):62-69.CrossRefGoogle ScholarPubMed
4.Sateia, MJ. Update on sleep and psychiatric disorders. Chest. 2009;135(5):1370-1379.CrossRefGoogle ScholarPubMed
5.Bonnet, MH, Arand, DL. Clinical effects of sleep fragmentation versus sleep deprivation. Sleep Med Rev. 2003;7(4):297-310.CrossRefGoogle ScholarPubMed
6.Kamba, M, Suto, Y, Ohta, Y, Inoue, Y, Matsuda, E. Cerebral metabolism in sleep apnea. Evaluation by magnetic resonance spectroscopy. Am J Respir Crit Care Med. 1997;156(1):296-298.CrossRefGoogle ScholarPubMed
7.Naegele, B, Pepin, LJ, Levy, P, Bonnet, C, Pellat, J, Feuerstein, C. Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS) after CPAP treatment. Sleep. 1998;21(4):392-397.CrossRefGoogle ScholarPubMed
8.Valencia-Flores, M, Bliwise, DL, Guilleminault, C, Cilveti, R, Clerk, A. Cognitive function in patients with sleep apnea after acute nocturnal nasal continuous positive airway pressure (CPAP) treatment: sleepiness and hypoxemia effects. J Clin Exp Neuropsychol. 1996;18(2):197-210.CrossRefGoogle ScholarPubMed
9.Bixler, EO, Vgontzas, AN, Lin, HM, et al. Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med. 2001;163(3 Pt 1):608-613.CrossRefGoogle ScholarPubMed
10.Nieto, FJ, Young, TB, Lind, BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA.. 2000;283(14):1829-1836.Google Scholar
11.Pepperell, JC, Ramdassingh-Dow, S, Crosthwaite, N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised parallel trial. Lancet. 2002;359(9302):204-210.CrossRefGoogle ScholarPubMed
12.Kristiansen, HA, Kværner, KJ, Akre, H, Øverland, B, Russel, MB. Sleep apnea headache in the general population. Cephalalgia. 2012;32(6):451-458.CrossRefGoogle ScholarPubMed
13.National Police Agency. http://www.npa.go.jp/archive/keibi/biki/higaijokyo.pdf. Accessed August 17, 2012.Google Scholar
14.Nojima, N, Kato, K, Kameda, H. Seismic risk assessment of urban lifelines under system interaction. Disaster Prevention Research Institute Annuals. 1995;34(B-2):27-44.Google Scholar
15.Nowbar, S, Burkart, KM, Gonzales, R, et al. Obesity-associated hypoventilation in hospitalized patients: prevalence, effects, and outcome. Am J Med. 2004;116(1):1-7.CrossRefGoogle ScholarPubMed
16.Shamsuzzaman, AS, Gersh, BJ, Somers, VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003;290(14):1906-1914.CrossRefGoogle ScholarPubMed
17.Hamilton, GS, Solin, P, Naughton, MT. Obstructive sleep apnoea and cardiovascular disease. Intern Med J. 2004;34(7):420-426.CrossRefGoogle ScholarPubMed
18.Kato, M, Roberts-Thomson, P, Phillips, BG, et al. Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation. 2000;102(21):2607-2610.CrossRefGoogle ScholarPubMed
19.Ip, MS, Tse, HF, Lam, B, et al. Endothelial function in obstructive sleep apnea and response to treatment. Am J Respir Crit Care Med. 2004;169(3):348-353.CrossRefGoogle ScholarPubMed
20.Mosko, S, Zetin, M, Glen, S, et al. Self-reported depressive symptomatology, mood ratings, and treatment outcome in sleep disorders patients. J Clin Psychol. 1989;45(1):51-60.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
21.Yamamoto, H, Akashiba, T, Kosaka, N, et al. Long-term effects nasal continuous positive air-way pressure on daytime sleepiness, mood and traffic accidents in patients with obstructive sleep apnoea. Respir Med. 2000;94(1):87-90.CrossRefGoogle Scholar
22.Montserrat, JM, Montserrat, F, Hernandez, L, et al. Effectiveness of CPAP treatment in daytime function in sleep apnea syndrome. Am J Respir Crit Care Med. 2001;164(4):608-613.CrossRefGoogle ScholarPubMed
23.Jenkinson, C, Davies, RJO, Mullins, R, et al. Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnea: a randomized prospective parallel trial. Lancet. 1999;353(9170):2100-2105.CrossRefGoogle ScholarPubMed
24.Sin, DD, Mayers, I, Man, GC, et al. Can continuous positive airway pressure therapy improve the general health status of patients with obstructive sleep apnea? A clinical effectiveness study. Chest. 2002;122(5):1679-1685.CrossRefGoogle ScholarPubMed
25.Kangala, R, Murali, N, Friedman, PA, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003;107(20):2589-2594.Google Scholar
26.Malone, S, Liu, PP, Holloway, R, et al. Obstructive sleep apnea in patients with dilated cardiomyopathy: effects of continuous positive airway pressure. Lancet. 1991;338(8781):1480-1484.Google ScholarPubMed
27.Kaneko, Y, Floras, JS, Kengo, U, et al. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003;348(13):1233-1241.CrossRefGoogle ScholarPubMed
28.Ryan, CM, Usui, K, Floras, JS, et al. Effect of continuous positive airway pressure on ventricular ectopy in heart failure patients with obstructive sleep apnea. Thorax. 2005;60(9):781-785.CrossRefGoogle Scholar
29.Baldwin, CM, Griffith, KA, Nieto, FJ, O'Connor, GT, Walsleben, JA, Redline, S. The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study. Sleep. 2001;24(1):96-105.CrossRefGoogle ScholarPubMed
30.Parish, JM, Lyng, PJ. Quality of life in bed partners of patients with obstructive sleep apnea or hypopnea after treatment with continuous positive airway pressure. Chest. 2003;124(3):942-947.CrossRefGoogle ScholarPubMed
31.Kohler, M, Stoewhas, AC, Ayers, L, et al. Effects of continuous positive airway pressure therapy withdrawal in patients with obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med. 2011;184(10):1192-1199.CrossRefGoogle ScholarPubMed
32.Sweet, LH, Jerskey, BA, Aloia, MS. Default network response to a working memory challenge after withdrawal of continuous positive airway pressure treatment for obstructive sleep apnea. Brain Imaging Behav. 2010;4(2):155-163.CrossRefGoogle ScholarPubMed
33.Phillips, CL, Yee, B, Yang, Q, et al. Effects of continuous positive airway pressure treatment and withdrawal in patients with obstructive sleep apnea on arterial stiffness and central BP. Chest. 2008;134(1):94-100.CrossRefGoogle ScholarPubMed
34.Phillips, CL, Yang, Q, Williams, A, et al. The effect of short-term withdrawal from continuous positive airway pressure therapy on sympathetic activity and markers of vascular inflammation in subjects with obstructive sleep apnoea. J Sleep Res. 2007;16(2):217-225.CrossRefGoogle ScholarPubMed
35.Rossi, VA, Stoewhas, AC, Camen, G, et al. The effects of continuous positive airway pressure therapy withdrawal on cardiac repolarization: data from a randomized controlled trial. Eur Heart J. 2012;33(17):2206-2212.CrossRefGoogle ScholarPubMed
36. 2011 Great East Japan Earthquake—JSCE Information Forum. http://committees.jsce.or.jp/2011quake/system/files/110603-ver3.pdf. Accessed September 3, 2012.Google Scholar
37.Engleman, HM, Wild, MR. Improving CPAP use by patients with the sleep apnea/hypopnea syndrome. Sleep Med Rev. 2003;7:81-99.CrossRefGoogle Scholar
38.Pepin, JL, Krieger, J, Rodenstein, D, et al. Effective compliance during the first 3 months of continuous positive airway pressure: a European prospective study of 121 patients. Am J Respir Crit Care Med. 1999;160(4):1124-1129.CrossRefGoogle ScholarPubMed
39.Sin, DD, Mayers, I, Man, GCW, et al. Long-term compliance rates to continuous positive airway pressure in obstructive sleep apnea. Chest. 2002;121(2):430-435.CrossRefGoogle ScholarPubMed
40.Nojima, N, Kameda, H. Fundamental structure of earthquake disaster countermeasures in lifeline systems. Disaster Prevention Research Institute Annuals. 1983;32(B-2):89-109.Google Scholar
4
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *