Emergent central sleep apnea during CPAP therapy-clinical implications
| Autor: | M. Jeffery Mador |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Central sleep apnea Polysomnography Central apnea index 03 medical and health sciences 0302 clinical medicine Cpap therapy Internal medicine medicine Humans International Classification of Sleep Disorders Sleep study Cpap titration Aged Monitoring Physiologic Aged 80 and over Continuous Positive Airway Pressure Titration Study business.industry Middle Aged medicine.disease Sleep Apnea Central Telemedicine respiratory tract diseases Obstructive sleep apnea Editorial Treatment Outcome 030228 respiratory system Anesthesia Cardiology Female business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Thoracic Disease. 9:4182-4184 |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2017.09.131 |
| Popis: | The emergence of central sleep apnea (CSA) during positive airway pressure (PAP) therapy has been observed clinically in approximately 10% of obstructive sleep apnea titration studies. This study assessed a PAP database to investigate trajectories of treatment-emergent CSA during continuous PAP (CPAP) therapy.U.S. telemonitoring device data were analyzed for the presence/absence of emergent CSA at baseline (week 1) and week 13. Defined groups were as follows: obstructive sleep apnea (average central apnea index [CAI] 5/h in week 1, 5/h in week 13); transient CSA (CAI ≥ 5/h in week 1, 5/h in week 13); persistent CSA (CAI ≥ 5/h in week 1, ≥ 5/h in week 13); emergent CSA (CAI 5/h in week 1, ≥ 5/h in week 13).Patients (133,006) used CPAP for ≥ 90 days and had ≥ 1 day with use of ≥ 1 h in week 1 and week 13. The proportion of patients with CSA in week 1 or week 13 was 3.5%; of these, CSA was transient, persistent, or emergent in 55.1%, 25.2%, and 19.7%, respectively. Patients with vs without treatment-emergent CSA were older, had higher residual apnea-hypopnea index and CAI at week 13, and more leaks (all P .001). Patients with any treatment-emergent CSA were at higher risk of therapy termination vs those who did not develop CSA (all P .001).Our study identified a variety of CSA trajectories during CPAP therapy, identifying several different clinical phenotypes. Identification of treatment-emergent CSA by telemonitoring could facilitate early intervention to reduce the risk of therapy discontinuation and shift to more efficient ventilator modalities. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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