Effects of Biofeedback Therapy on Cardiovascular and Respiratory Indices in NREM Sleep Parasomnias with Obstructive Sleep Apnea: A Case study

Introduction: Non-REM parasomnias are a relatively common condition in the general human population. Current treatment plans are usually based on small case series and reports. Considering the effects of sleep disorders on different aspects of human life and the failure of pharmacological treatments in this field, the present study was designed to investigate a case of this sleep disorders with obstructive sleep apnea and related treatment strategies based on the patient's psychological, physical, and cognitive characteristics. Methods: The studied subject in the present study was a 60-years-old man with a family history of sleepwalking disorders. The treatment plan in the present study was as follows: Execution of the principles of sleep hygiene by the patient, use of continuous positive airway pressure machine (CPAP), and eight weekly biofeedback therapy sessions (including the use of mental exercises for the patient with the use of heart rate sensors, respiration rate per minute, and coordination of respiratory and cardiovascular events). Before the start and after the end of the treatment period, cardiovascular parameters such as blood pressure, arterial blood oxygen saturation, heart rate, and respiratory parameters (apnea, hypopnea, etc.) were measured. The data obtained from the device were presented by drawing appropriate graphs and tables. Results: Prior to the interventions, the number of obstructive sleep apnea were 34 times and the number of obstructive hypopnea was 106 times. After the therapeutic interventions, the obstructive sleep apnea completely disappeared and the number of obstructive hypopnea was reported only 12 times. Before interventions, the incidence of oxygen desaturation events was 389, accounting for 24% of total sleep time. After therapeutic interventions, the rate of events related to oxygen desaturation decreased to 102 times. Conclusion: The treatment plan in this study resulted in complete improvement in some parameters such as obstructive sleep apnea and the relative improvement in others such as arterial blood oxygen pressure and heart rate. The present study was able to explore and clarify new aspects, both in terms of identifying the mechanisms of the disorder and in terms of treatment.