Efficacy of Bilevel-auto Treatment in Patients with Obstructive Sleep Apnea Not Responsive to or Intolerant of Continuous Positive Airway Pressure Ventilation.

Autor:	Carlucci A; Pulmonary Rehabilitation, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Ceriana P; Pulmonary Rehabilitation, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Mancini M; Pulmonary Rehabilitation, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Cirio S; Pulmonary Rehabilitation, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Pierucci P; Department of Thoracic Medicine, St. Vincent's Hospital, Darlinghurst NSW, Australia., D'Artavilla Lupo N; Sleep Medicine Unit, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Gadaleta F; Sleep Medicine Unit, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Morrone E; Sleep Medicine Unit, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy., Fanfulla F; Sleep Medicine Unit, Fondazione Salvatore Maugeri IRCCS - Scientific Institute of Pavia, Pavia, Italy.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2015 Sep 15; Vol. 11 (9), pp. 981-5. Date of Electronic Publication: 2015 Sep 15.
DOI:	10.5664/jcsm.5008
Abstrakt:	Background: Ventilation with continuous positive airway pressure (CPAP) is the gold standard therapy for obstructive sleep apnea (OSA). However, it was recently suggested that a novel mode of ventilation, Bilevel-auto, could be equally effective in treating patients unable to tolerate CPAP. The aim of this study was to investigate the ability of Bilevel-auto to treat OSA patients whose nocturnal ventilatory disturbances are not completely corrected by CPAP. Methods: We enrolled 66 consecutive OSA patients, not responsive to (group A) or intolerant of (group B) CPAP treatment, after a full night of manual CPAP titration in a laboratory. Full polysomnography data and daytime sleepiness score were compared for each group in the three different conditions: basal, during CPAP, and during Bilevel-auto. Results: The apnea-hypopnea index decreased significantly during CPAP in both groups; however, in the group A, there was a further significant improvement during Bilevel-auto. The same trend was observed for oxygenation indices, while the distribution and the efficiency of sleep did not differ following the switch from CPAP to Bilevel-auto. Conclusions: This study confirmed the role of Bilevel-auto as an effective therapeutic alternative to CPAP in patients intolerant of this latter mode of ventilation. Moreover, extending the use of Bilevel-auto to those OSA patients not responsive to CPAP, we showed a significantly better correction of nocturnal respiratory disturbances. (© 2015 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
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