Differences in breathing patterning during wakefulness in patients with mixed apnea-dominant vs obstructive-dominant sleep apnea
| Autor: | Hiroshi Kimura, Shinji Tamaki, Kingman P. Strohl, Frank J. Jacono, Hiroshi Nakano, Motoo Yamauchi, Masanori Yoshikawa, Yoshinobu Ohnishi, Kenneth A. Loparo |
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| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_treatment Polysomnography Polysomnogram Critical Care and Intensive Care Medicine Severity of Illness Index Diagnosis Differential Medicine Respiratory inductance plethysmography Humans Continuous positive airway pressure Wakefulness Retrospective Studies Original Research Sleep Apnea Obstructive medicine.diagnostic_test business.industry Respiration Sleep apnea Apnea Middle Aged medicine.disease Prognosis Sleep Apnea Central nervous system diseases respiratory tract diseases Respiratory Function Tests Obstructive sleep apnea Anesthesia Female medicine.symptom Sleep onset Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Chest. 140(1) |
| ISSN: | 1931-3543 |
| Popis: | Background Mixed apneas share both central and obstructive components and are often treated as if they are obstructive events. The hypothesis is that patients with obstructive sleep apnea syndrome (OSAS) who exhibit a majority of mixed apneas will differ in ventilatory control from those with predominantly obstructive apneas during wakefulness; moreover, this difference could affect nasal continuous positive airway pressure (CPAP) adherence. Methods In a retrospectively derived case-control study, 5 min of respiratory inductance plethysmography signals during wakefulness prior to sleep onset were extracted from a diagnostic polysomnogram in these groups: (1) mixed apnea-dominant OSAS (mix-OSAS) (n = 36), (2) obstructive apnea-dominant OSAS (pure-OSAS) (n = 20), (3) central apnea-dominant sleep apnea syndrome (pure-CSAS) (n = 6), and (4) control subjects (n = 10). Breathing patterning was compared between the groups using the coefficient of variation (CV) for breath-to-breath inspiration time (T i ), expiration time (T e ), T i + T e (Ttot), and tidal volume, and an information theory-based metric of signal pattern variability (sample entropy). Subsequent CPAP adherence over 12 months was determined in OSAS groups. Results Breath-to-breath CV parameters and sample entropy in the mix-OSAS group were significantly greater as compared with the pure-OSAS and control groups. In a subanalysis, CV and sample entropy were similar in the mix-OSAS and the pure-CSAS groups. CPAP adherence was significantly poorer in mix-OSAS compared with pure-OSAS. Conclusions During wakefulness, both breath patterning and sample entropy in mix-OSAS are similar to pure-CSAS and more variable than in pure-OSAS. In addition, CPAP adherence was decreased in patients with mix-OSAS, which may be related to basic differences in respiratory control. |
| Databáze: | OpenAIRE |
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