• Laura H White, Owen D Lyons, Azadeh Yadollahi, Clodagh M Ryan, and T Douglas Bradley.
• Sleep Research Laboratory of the University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada; Centre for Sleep Medicine and Circadian Biology of the University of Toronto, Toronto, ON, Canada.
• Sleep Med. 2015 Feb 1; 16 (2): 258-64.

BackgroundOvernight fluid shift from the legs to the neck may narrow the upper airway and contribute to obstructive sleep apnea (OSA) pathogenesis. We hypothesized that below-the-knee compression stockings will decrease OSA severity in a general OSA population by decreasing daytime leg fluid accumulation and overnight fluid shift and increasing upper-airway size.MethodsPatients with OSA (apnea-hypopnea index ≥ 10) were randomized to wear compression stockings during the daytime or to a control group for 2 weeks. Overnight polysomnography with measurement of leg and neck fluid volumes and upper-airway cross-sectional area before and after sleep was performed at baseline and follow-up. The primary outcome was change in the apnea-hypopnea index.ResultsTwenty-two patients randomized to compression stockings and 23 to control completed the study. The apnea-hypopnea index decreased significantly more in the compression stockings than in the control group (from 32.4 ± 20.0 to 23.8 ± 15.5 vs. from 31.2 ± 25.0 to 30.3 ± 23.8, p = 0.042), in association with a significantly greater reduction in the overnight decrease in leg fluid volume (p = 0.028), and a significantly greater increase in morning upper-airway cross-sectional area (p = 0.006). Overnight change in neck fluid volume was unchanged.ConclusionThese observations suggest that in, a general OSA population, below-the-knee compression stockings decrease OSA severity modestly via attenuation of overnight fluid shift and consequent upper-airway dilatation.Copyright © 2014 Elsevier B.V. All rights reserved.

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