Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 Oct;65(4):497–501. doi: 10.1136/jnnp.65.4.497

Effects of transient and persistent cerebrospinal fluid drainage on sleep disordered breathing in patients with idiopathic adult hydrocephalus syndrome

B Kristensen 1, J Malm 1, T Rabben 1
PMCID: PMC2170295  PMID: 9771772

Abstract

OBJECTIVES—To examine sleep disordered breathing including obstructive sleep apnoea in patients with idiopathic adult hydrocephalus syndrome (IAHS) and to study the effects of CSF drainage and shunting procedure on sleep disordered breathing.
METHODS—In 17 patients with IAHS polysomnographic investigations were performed before and after lumbar CSF drainage and after shunt operation.
RESULTS—Baseline investigations documented a high prevalence of sleep related obstructive respiratory events (respiratory disturbance index >10 in 65% of the patients) and impaired sleep structure. There was no correlation between respiratory disturbance index and CSF pressure. Minimum oxygen saturation was highly correlated with cognitive function. Neither lumbar CSF drainage nor shunting alleviated the respiratory disturbance index. REM and delta sleep increased initially after shunting but there was no sustained effect on sleep quality.
CONCLUSIONS—Sleep disordered breathing is a prevalent finding in patients with IAHS. The shortcoming of CSF drainage to improve sleep disordered breathing either transiently or permanently implies that sleep disordered breathing is a coexistent condition, or an irreversible consequence of the hydrocephalus, with a potential of causing additional dysfunction in IAHS.



Full Text

The Full Text of this article is available as a PDF (101.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ancoli-Israel S., Kripke D. F., Klauber M. R., Mason W. J., Fell R., Kaplan O. Sleep-disordered breathing in community-dwelling elderly. Sleep. 1991 Dec;14(6):486–495. doi: 10.1093/sleep/14.6.486. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bradley W. G., Jr, Whittemore A. R., Watanabe A. S., Davis S. J., Teresi L. M., Homyak M. Association of deep white matter infarction with chronic communicating hydrocephalus: implications regarding the possible origin of normal-pressure hydrocephalus. AJNR Am J Neuroradiol. 1991 Jan-Feb;12(1):31–39. [PMC free article] [PubMed] [Google Scholar]
  3. Ekstedt J. CSF hydrodynamic studies in man. 1. Method of constant pressure CSF infusion. J Neurol Neurosurg Psychiatry. 1977 Feb;40(2):105–119. doi: 10.1136/jnnp.40.2.105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Ekstedt J. CSF hydrodynamic studies in man. 2 . Normal hydrodynamic variables related to CSF pressure and flow. J Neurol Neurosurg Psychiatry. 1978 Apr;41(4):345–353. doi: 10.1136/jnnp.41.4.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fleury B. Sleep apnea syndrome in the elderly. Sleep. 1992 Dec;15(6 Suppl):S39–S41. doi: 10.1093/sleep/15.suppl_6.s39. [DOI] [PubMed] [Google Scholar]
  6. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  7. Gislason T., Almqvist M., Eriksson G., Taube A., Boman G. Prevalence of sleep apnea syndrome among Swedish men--an epidemiological study. J Clin Epidemiol. 1988;41(6):571–576. doi: 10.1016/0895-4356(88)90061-3. [DOI] [PubMed] [Google Scholar]
  8. Graff-Radford N. R., Godersky J. C. Idiopathic normal pressure hydrocephalus and systemic hypertension. Neurology. 1987 May;37(5):868–871. doi: 10.1212/wnl.37.5.868. [DOI] [PubMed] [Google Scholar]
  9. Hachinski V. C., Iliff L. D., Zilhka E., Du Boulay G. H., McAllister V. L., Marshall J., Russell R. W., Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. doi: 10.1001/archneur.1975.00490510088009. [DOI] [PubMed] [Google Scholar]
  10. Jennum P., Børgesen S. E. Intracranial pressure and obstructive sleep apnea. Chest. 1989 Feb;95(2):279–283. doi: 10.1378/chest.95.2.279. [DOI] [PubMed] [Google Scholar]
  11. Krauss J. K., Droste D. W., Bohus M., Regel J. P., Scheremet R., Riemann D., Seeger W. The relation of intracranial pressure B-waves to different sleep stages in patients with suspected normal pressure hydrocephalus. Acta Neurochir (Wien) 1995;136(3-4):195–203. doi: 10.1007/BF01410626. [DOI] [PubMed] [Google Scholar]
  12. Krauss J. K., Regel J. P., Vach W., Droste D. W., Borremans J. J., Mergner T. Vascular risk factors and arteriosclerotic disease in idiopathic normal-pressure hydrocephalus of the elderly. Stroke. 1996 Jan;27(1):24–29. doi: 10.1161/01.str.27.1.24. [DOI] [PubMed] [Google Scholar]
  13. Krauss J. K., Regel J. P., Vach W., Orszagh M., Jüngling F. D., Bohus M., Droste D. W. White matter lesions in patients with idiopathic normal pressure hydrocephalus and in an age-matched control group: a comparative study. Neurosurgery. 1997 Mar;40(3):491–496. doi: 10.1097/00006123-199703000-00011. [DOI] [PubMed] [Google Scholar]
  14. Kristensen B., Malm J., Fagerland M., Hietala S. O., Johansson B., Ekstedt J., Karlsson T. Regional cerebral blood flow, white matter abnormalities, and cerebrospinal fluid hydrodynamics in patients with idiopathic adult hydrocephalus syndrome. J Neurol Neurosurg Psychiatry. 1996 Mar;60(3):282–288. doi: 10.1136/jnnp.60.3.282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Kuchiwaki H., Takada S., Ishiguri H., Kageyama N., Terashima M., Furuse M., Sugiura M. Pressure wave with apnoea evaluated by sleep level in patient with ventricular dilation. Neurol Res. 1988 Jun;10(2):105–111. doi: 10.1080/01616412.1988.11739824. [DOI] [PubMed] [Google Scholar]
  16. MAHONEY F. I., BARTHEL D. W. FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965 Feb;14:61–65. [PubMed] [Google Scholar]
  17. Malm J., Kristensen B., Fagerlund M., Koskinen L. O., Ekstedt J. Cerebrospinal fluid shunt dynamics in patients with idiopathic adult hydrocephalus syndrome. J Neurol Neurosurg Psychiatry. 1995 Jun;58(6):715–723. doi: 10.1136/jnnp.58.6.715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Malm J., Kristensen B., Karlsson T., Fagerlund M., Elfverson J., Ekstedt J. The predictive value of cerebrospinal fluid dynamic tests in patients with th idiopathic adult hydrocephalus syndrome. Arch Neurol. 1995 Aug;52(8):783–789. doi: 10.1001/archneur.1995.00540320059013. [DOI] [PubMed] [Google Scholar]
  19. McNamara M. E., Millman R. P., Epstein M. H., Fogel B. S. The association of normal-pressure hydrocephalus with obstructive sleep apnea. J Geriatr Psychiatry Neurol. 1992 Oct-Dec;5(4):238–240. doi: 10.1177/002383099200500410. [DOI] [PubMed] [Google Scholar]
  20. Newell D. W., Aaslid R., Stooss R., Reulen H. J. The relationship of blood flow velocity fluctuations to intracranial pressure B waves. J Neurosurg. 1992 Mar;76(3):415–421. doi: 10.3171/jns.1992.76.3.0415. [DOI] [PubMed] [Google Scholar]
  21. Young T., Palta M., Dempsey J., Skatrud J., Weber S., Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993 Apr 29;328(17):1230–1235. doi: 10.1056/NEJM199304293281704. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES