• 2
    Sep
  • Results of Effects of Medroxyprogesterone Acetate in Obstructive Sleep Apnea

disordered breathingTable 2 gives the total time in apnea as a percentage of total sleep time, the number of episodes of apnea per hour of sleep, and the decrements in Sa02 during apnea for each patient before, during, and after treatment. Table 3 gives the same information for episodes of disordered breathing. All patients continued to have apneic episodes during and following treatment. There were no significant differences among the group means before, during, and after treatment for either apneic or disordered breathing episodes. Examination of Tables 2 and 3 reveals that there was no consistent pattern of responses to medroxyprogesterone over all variables among the different patients.

The total times spent in apnea and disordered breathing episodes, expressed as percentages of total sleep time, are shown in Figure 1. There were no significant differences in mean percentage of time in apnea before (20.8±3.5 percent [±SE]), during (18.6 ±4.3 percent), and after (16.9 ±4.5 percent) medroxyprogesterone. Likewise, there were no differences in the mean percentages of disordered breathing time before (17.0±6.1 percent), during (17.4±5.3 percent), or after (21.6 ±6.8 percent) the drug. The mean durations of apneic and disordered breathing episodes for all patients are shown in Figure 2. There were no significant changes associated with administration of medroxyprogesterone. The distribution for the number of apneic episodes by duration is given in Figure 3. Again, there was no difference in mean values resulting from treatment.

There were no significant differences in the mean values for arterial oxygen desaturation for all patients obtained during periods of abnormal breathing before, during, and after treatment with medroxyprogesterone (Fig 4). Treatment resulted in no significant differences in the mean reductions in SaOs occurring during apnea and disordered breathing.

The mean slopes for linear regressions of minute ventilation and occlusion pressure on end-tidal Pco2 before, during, and after treatment with medroxyprogesterone are shown in Figure 5. During treatment, mean slopes for both ventilation and P100 responses were significantly greater (p<0.05) than the values before treatment. The means for both responses after treatment were between the values obtained before and during treatment and were not significantly different from the values obtained before or during treatment.

Using the Pearson product-moment test, no significant correlation was found between a patient s height, weight, or pulmonary function and the changes in apnea, disordered breathing, and respiratory drives with treatment. Treatment is key element of disorder fighting that’s why you should be in touch with the latest technologies about which you may read here – Visit to Canadian Health Care – news online.

Figure 6 shows the mean percentages of total sleep time spent in stages 1 and 2, in stages 3 and 4, and in REM sleep for all patients. There were no significant differences between the values obtained before and during treatment with medroxyprogesterone; however, after cessation of treatment, the percentage of sleep time spent in stages 1 and 2 was significantly less (p<0.05) than that before and during treatment, and the percentage of REM sleep was significantly greater than before and during treatment.

Table 2—Episodes of Apnea before, during, and after Therapy with Medroxyprogesterone Acetate in Obstructive Sleep Apnea

Patient Apnea Time as Percent of Total Sleep Time No. of Apneic Episodes per Hour of Sleep Mean Lowest Arterial Oxygen Desaturation during Apnea, percent
Before During After Before During After Before During After
1 17.2 5.6 1.5 33.8 10.2 3.6 5.6 10.7 5.2
2 3.8 3.7 1.2 7.9 5.2 2.0 9.0 9.9 2.5
3 30.2 15.8 23.2 31.1 18.5 29.4 24.0 7.0 14.1
4 46.1 37.5 52.3 84.7 71.6 83.5 7.1 6.2 7.3
5 10.5 5.6 6.0 22.4 8.2 8.9 12.7 25.9 18.8
6 10.0 12.4 8.4 10.2 15.9 15.3 12.3 22.8 8.8
7 38.3 37.0 21.9 49.1 52.6 22.4 18.0 16.7 23.9
8 28.6 5.8 16.5 44.2 10.5 23.7 9.9 14.0 15.2
9 16.9 13.0 22.6 29.9 19.4 39.2 12.1 7.0 5.2
10 23.5 20.2 26.8 27.0 22.9 26.0 8.7 19.0 22.8
11 13.8 32.6 5.8 15.6 36.6 5.2 19.4 12.9 6.0
12 24.1 48.9 39.6 70.8 5.4 7.6
13 7.5 3.7 11.6 6.5 5.8 2.3
Mean 20.8 18.6 16.9 31.3 26.8 23.6 11.5 12.5 11.8
SE 3.5 4.3 4.5 5.7 6.6 7.0 1.6 1.9 2.3

Table 3—Episodes of Disordered Breathing before, during,, and after Medroxyprogesterone Acetate in Obstructive Sleep Apnea

Patient Disordered Breathing Time as Percent of Total Sleep Time No. of Disordered Episodes per Hour of Sleep Mean Lowest Arterial Oxygen Desaturation during Disordered Breathing, percent
Before During After Before During After Before During After
1 15.4 0.0 1.5 23.7 0.0 2.5 12.0 7.8
2 0.5 9.5 0.4 1.2 12.3 0.6 6.0 8.3 3.5
3 13.1 10.5 20.9 10.3 12.9 20.0 22.1 6.8 13.5
4 0.5 1.4 0.0 0.7 2.2 0.0 7.0 5.9
5 7.5 2.4 7.6 11.2 3.4 8.1 13.8 19.7 18.5
6 8.5 18.3 10.4 9.9 24.4 14.7 14.3 17.9 13.3
7 14.4 22.7 48.7 19.1 31.2 49.6 12.4 13.1 19.9
8 10.6 15.9 16.3 17.0 23.6 22.1 6.4 6.7 9.2
9 21.2 34.5 23.3 35.8 51.7 35.9 7.6 5.3 5.7
10 44.5 48.1 38.0 45.2 53.1 39.0 18.4 11.8 13.4
11 79.3 59.5 70.5 69.5 57.4 61.2 20.4 20.7 21.9
12 4.2 1.8 7.2 2.5 4.0 4.8
13 0.7 1.8 1.1 3.3 5.4 2.6
Mean 17.0 17.4 21.6 19.4 21.4 23.1 11.5 10.3 12.7
SE 6.1 5.3 6.8 5.6 5.8 6.3 1.7 1.8 2.0

Figure 1. Percentage of total sleep time spent in episodes of apnea and disordered breathing before, during, and after treatment with medroxyprogesterone acetate (MPA). Values shown are means for all patients (±SE). There were no significant differences associated with treatment

Figure 1. Percentage of total sleep time spent in episodes of apnea and disordered breathing before, during, and after treatment with medroxyprogesterone acetate (MPA). Values shown are means for all patients (±SE). There were no significant differences associated with treatment

Figure 2. Mean duration of episodes of apnea and disordered breathing for all patients. Brackets indicate ±SE. There were no significant differences associated with treatment with medroxyprogesterone acetate (MPA).

Figure 2. Mean duration of episodes of apnea and disordered breathing for all patients. Brackets indicate ±SE. There were no significant differences associated with treatment with medroxyprogesterone acetate (MPA).

Figure 3. Mean numbers of episodes of apnea of various durations for all patients before, during, and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. There were no significant differences associated with treatment.

Figure 3. Mean numbers of episodes of apnea of various durations for all patients before, during, and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. There were no significant differences associated with treatment.

Figure 4. Mean reduction in Sa02 occurring in episodes of apnea and disordered breathing for all patients before, during, and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. There were no significant differences associated with treatment.

Figure 4. Mean reduction in Sa02 occurring in episodes of apnea and disordered breathing for all patients before, during, and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. There were no significant differences associated with treatment.

Figure 5. Mean slopes of linear regressions of minute ventilation (Ve) and occlusion pressure (P100) responses on expired Pco8 for all patients before, during and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. Asterisk indicates mean value obtained during treatment significantly greater (p<0.05) than before treatment

Figure 5. Mean slopes of linear regressions of minute ventilation (Ve) and occlusion pressure (P100) responses on expired Pco8 for all patients before, during and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. Asterisk indicates mean value obtained during treatment significantly greater (p<0.05) than before treatment

Figure 6. Mean percentage of sleep time spent in different sleep stages for all patients before, during, and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. Asterisk indicates value after treatment significantly different (p<0.05) finom during treatment and before treatment.

Figure 6. Mean percentage of sleep time spent in different sleep stages for all patients before, during, and after treatment with medroxyprogesterone acetate (MPA). Brackets indicate ± SE. Asterisk indicates value after treatment significantly different (p<0.05) finom during treatment and before treatment.

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