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Effects of Compression Stockings on the Risk of Obstructive Sleep Apnea (OSA) in Hemodialysis Patients

*Astilia Astilia  -  Universitas Padjadjaran, Indonesia
Ria Bandiara  -  Universitas Padjadjaran, Indonesia
Cecep Eli Kosasih  -  Universitas Padjadjaran, Indonesia
Kusman Ibrahim  -  Universitas Padjadjaran, Indonesia
Open Access Copyright (c) 2020 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Background: Obstruction Sleep Apnea (OSA) in hemodialysis patients is a sleep disorder that involves stopping or decreasing air flow to breathe during sleep due to excess fluid in the leg. Compression Stockings (CS) with 30-40 mmHg are high pressure elastic stockings that are assumed to reduce foot fluid accumulation during the day and to prevent overnight fluid shifting to the neck.

Purpose: This study aimed to determine the effects of 30-40 mmHg CS on the risk of OSA in hemodialysis patients.

Method: This research used a quasi-experimental pre-posttest with control group design. A purposive sampling was applied to recruit as many as 68 hemodialysis patients. The risk score of OSA was measured using STOP Bang questionnaire. High pressure CS were given for one week to the intervention group with two OSA measurements on the 4th and 7th days. The data then were analyzed using the Post Hoc Wilcoxon test and the Mann Whitney test.

Results: There was a significant difference between the risk score for OSA before and after the use of 30-40 mmHg Compression Stocking in the intervention group on day 4 (p=0.000) and day 7 (p=0.000) compared to the control group.

Conclusion:  High pressure CS decreased the risk of OSA in hemodialysis patients by avoiding fluid retention in the legs, thus preventing fluid shifting to the neck. CS should be recommended as an alternative to prevent the risk of OSA in hemodialysis patients.

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Keywords: Compression stockings; fluid shift; hemodialysis; obstructive sleep apnea

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  1. Abuyassin, B., Sharma, K., Ayas, N. T., & Laher, I. (2015). Obstructive slee apnea and kidney disease: a potential bidirectional relationship?. Journal of Clinical Sleep Medicine, 11(8), 915-924. doi: 10.5664/jcsm.4946
  2. Antariksa B. (2010). Obstructive Sleep Apnea (OSA). Journal Respirasi Indonesia. 30(1), 102-5
  3. Beecroft, J. M., Pierratos, A., & Hanly, P. J. (2009). Clinical presentation of obstructive sleep apnea in patients with end-stage renal disease. Journal of Clinical Sleep Medicine, 5(2), 115-121
  4. Budiarsa, I. G. N. (2016). Obstructive sleep apnea pada lansia [Obstructive sleep apnea in The Elderly]. Neurology in Elderly, 4, 40-56
  5. Cataldo, J. L., de Godoy, J. P., & De Barros, N. (2012). The use of compression stockings for venous disorders in Brazil. Phlebology, 27(1), 33-37
  6. De Vries, N., Ravesloot, M., & Van Maanen, J. P. (Eds.). (2015). Positional therapy in obstructive sleep apnea. Springer International Publishing
  7. dos Reis Santos, I., Danaga, A. R., de Carvalho Aguiar, I., Oliveira, E. F., Dias, I. S., et. al. (2013). Cardiovascular risk and mortality in end-stage renal disease patients undergoing dialysis: sleep study, pulmonary function, respiratory mechanics, upper airway collapsibility, autonomic nervous activity, depression, anxiety, stress and quality of life: a prospective, double blind, randomized controlled clinical trial. BMC Nephrology, 14, 215. doi: 10.1186/1471-2369-14-215
  8. Elias, R. M., Castro, M. C. M., De Queiroz, E. L., Abensur, H., Romão-Junior, J. E., & Lorenzi-Filho, G. (2009). Obstructive sleep apnea in patients on conventional and short daily hemodialysis. American journal of nephrology, 29(6), 493-500
  9. Elias, R. M., Bradley, T. D., Kasai, T., Motwani, S. S., & Chan, C. T. (2011). Rostral overnight fluid shift in end-stage renal disease: relationship with obstructive sleep apnea. Nephrology Dialysis Transplantation, 27(4), 1569-1573
  10. Elias, R. M., Chan, C. T., Paul, N., Motwani, S. S., Kasai, T., Gabriel, J. M., ... & Bradley, T. D. (2012). Relationship of pharyngeal water content and jugular volume with severity of obstructive sleep apnea in renal failure. Nephrology Dialysis Transplantation, 28(4), 937-944
  11. Elysabeth, D., Libranty, G., & Natalia, S. (2015). Hubungan tingkat pendidikan perawat dengan kompetensi aplikasi evidence-based practice [Correlation between nurse's education level and the competency to do evidence-based practice]. Jurnal Skolastik Keperawatan, 1(01), 130265
  12. Feng, J., & Chen, B. Y. (2009). Prevalence and incidence of hypertension in obstructive sleep apnea patients and the relationship between obstructive sleep apnea and its confounders. Chinese Medical Journal, 122(12), 1464
  13. Friedman, O., Bradley, T. D., Ruttanaumpawan, P., & Logan, A. G. (2010). Independent association of drug-resistant hypertension to reduced sleep duration and efficiency. American journal of hypertension, 23(2), 174-179
  14. Gibson, A. L., Beam, J. R., Alencar, M. K., Zuhl, M. N., & Mermier, C. M. (2015). Time course of supine and standing shifts in total body, intracellular and extracellular water for a sample of healthy adults. European journal of clinical nutrition, 69(1), 14
  15. International Society of Lymphology. (2013). The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology, 46(1), 1-11
  16. Lam, J. C., Sharma, S. K., & Lam, B. (2010). Obstructive sleep apnea: Definitions, epidemiology & natural history. Indian Journal of Medical Research, 131(2), 165
  17. Lim, C. S., & Davies, A. H. (2014). Graduated compression stockings. Canadian Medical Association Journal, 186(10), E391-E398
  18. Ministry of Health Republic of Indonesia (2013). Riskesdas: Prevelensi gagal ginjal kronik di Indonesia
  19. Kerns, E. S., Kim, E. D., Meoni, L. A., Sozio, S. M., Jaar, B. G., Estrella, M. M., Parekh, R. S & Bourjeily, G. (2018). Obstructive sleep apnea increases sudden cardiac death in incident hemodialysis patients. American journal of nephrology, 48(2), 147-156
  20. Kikuchi, K., Holdway, J. E., Werdich, A. A., Anderson, R. M., Fang, Y., Egnaczyk, G. F., & Poss, K. D. (2010). Primary contribution to zebrafish heart regeneration by gata4+ cardiomyocytes. Nature, 464(7288), 601
  21. Nelson, E. A., & Bell‐Syer, S. E. (2012). Compression for preventing recurrence of venous ulcers. Cochrane Database of Systematic Reviews, (9). doi: 10.1002/14651858.CD002303.pub3
  22. Ogna, A., Forni Ogna, V., Mihalache, A., Pruijm, M., Halabi, G., Phan, O., & Heinzer, R. (2015). Obstructive sleep apnea severity and overnight body fluid shift before and after hemodialysis. Clinical Journal of the merican Society of Nephrology, 10(6), 1002–1010. doi: 10.2215/CJN.08760914
  23. Özdemir, Ö. C., Sevim, S., Duygu, E., Tuğral, A., & Bakar, Y. (2016). The effects of short-term use of compression stockings on health related quality of life in patients with chronic venous insufficiency. Journal of physical therapy science, 28(7), 1988-92. doi: 10.1589/jpts.28.1988
  24. Partsch, H. F. M. S. P. C. (2008). Indications for compression therapy in venous and lymphatic disease Consensus based on experimental data and scientific evidence under the auspices of the IUP. International Angiology, 27(3), 19
  25. Indonesia Renal Registry, (2018). Perhimpunan Nefrologi Indonesia (PERNEFREI). 11th Annual Report of Indonesia Renal Registry
  26. Punjabi, N. M. (2008). The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society, 5(2), 136-143
  27. Redolfi, S., Arnulf, I., Pottier, M., Lajou, J., Koskas, I., Bradley, T. D., & Similowski, T. (2011a). Attenuation of obstructive sleep apnea by compression stockings in subjects with venous insufficiency. American journal of respiratory and ritical care medicine, 184(9), 1062-1066. doi: 10.1164/rccm.201102-0350OC
  28. Redolfi, S., Arnulf, I., Pottier, M., Bradley, T. D., & Similowski, T. (2011b). Effects of venous compression of the legs on overnight rostral fluid shift and obstructive sleep apnea. Respiratory physiology & neurobiology, 175(3), 390-393
  29. Setyaningrum, S. D., Yunika, K., & Andhitara, Y. (2017). Hubungan antara fungsi kognitif dengan riwayat obstructive sleep apnea syndrome (osas) pada pasien pasca stroke iskemik di RSUP Dr Kariadi (Doctoral Dissertation, Faculty of Medicine)
  30. Silva, B. C., Santos, R. S., Drager, L. F., Coelho, F. M., & Elias, R. M. (2017). Impact of compression stockings vs continuous positive airway pressure on overnight fluid shift and obstructive sleep apnea among patients on hemodialysis. Frontiers in Medicine, 4, 57. doi: 10.3389/fmed.2017.00057
  31. Tori, M., Suryawati, H., & Husni, A. (2018). The relationship of anthropometry size with the apnea sleep obstructive DEGREE.Neurona (Majalah Kedokteran Neuro Sains Perhimpunan Dokter Spesialis Saraf Indonesia), 35(2)
  32. Wali, S. O., Alkhouli, A., Howladar, M., Ahmad, I., Alshohaib, S., Al-Ghamdi, S., & Krayem, A. (2015). Risk of obstructive sleep apnea among Saudis with chronic renal failure on hemodialysis. Annals of thoracic medicine, 10(4), 263. doi: 10.4103/1817-1737.164300
  33. White, L. H., Lyons, O. D., Yadollahi, A., Ryan, C. M., & Bradley, T. D. (2015b). Effect of below-the-knee compression stockings on severity of obstructive sleep apnea. Sleep medicine, 16(2), 258-264
  34. Windi, M., Yonathan, S., Theresia, R., & Finny, W. (2018). Risk relationship between apnea (osa) sleep obstructive with ischemic stroke incidence in RSUP Prof. DR. Kandou Manado: Association between official by sleep apnea (osa) and ischemic stroke inc. Jurnal Sinaps, 1(2), 29-35
  35. Yumino D, Redolfi S, Ruttanaumpawan P, et al. (2010). Nocturnal rostral fluid shift: A unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure. Circulation, 121, 1598-1605

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