Upper airway collapsibility in patients with OSA treated with continuous positive airway pressure: a retrospective preliminary study
| Autor: | Venerino Poletti, Marcello Bosi, Giulio Alessandri-Bonetti, Serena Incerti Parenti, Andrea Fiordelli |
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| Přispěvatelé: | Bosi M., Incerti Parenti S., Fiordelli A., Poletti V., Alessandri-Bonetti G. |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Moderate to severe medicine.medical_treatment Continuous positive airway pressure TITRATION DIAGNOSIS upper airway collapsibility PHYSIOLOGICAL TRAITS OBSTRUCTIVE SLEEP-APNEA MANAGEMENT Humans Medicine In patient POLYSOMNOGRAPHY AUTOTITRATION Wakefulness obstructive sleep apnea Retrospective Studies Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry Sleep Apnea Obstructive/therapy UVULOPALATOPHARYNGOPLASTY CARE respiratory system medicine.disease Scientific Investigations Obstructive sleep apnea respiratory tract diseases Upper airway collapsibility Neurology Anesthesia TRIAL Neurology (clinical) Sleep Airway business |
| Zdroj: | Bosi, M, Incerti Parenti, S, Fiordelli, A, Poletti, V & Alessandri-Bonetti, G 2020, ' Upper airway collapsibility in patients with OSA treated with continuous positive airway pressure : a retrospective preliminary study ', Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, vol. 16, no. 11, pp. 1839-1846 . https://doi.org/10.5664/jcsm.8674 J Clin Sleep Med |
| ISSN: | 1550-9397 1550-9389 |
| DOI: | 10.5664/jcsm.8674 |
| Popis: | STUDY OBJECTIVES: To investigate the prevalence of mildly collapsible upper airways (defined by therapeutic continuous positive airway pressure [CPAP] values ≤ 8 cm H(2)O) in moderate to severe obstructive sleep apnea patients treated with CPAP and to determine their clinical, functional, and nocturnal polysomnographic characteristics. METHODS: Eighty-seven patients with moderate to severe obstructive sleep apnea consecutively treated with CPAP were retrospectively investigated. Two nocturnal home sleep portable monitoring studies were performed at baseline and during treatment. Participants were categorized according to therapeutic CPAP values: ≤ 8 cm H(2)O (group 1), 8–12 cm H(2)O (group 2), ≥ 12 cm H(2)O (group 3). Anthropometric, awake respiratory function, symptoms, comorbidities, and nocturnal home sleep portable monitoring studies data were collected. RESULTS: Mild upper airway collapsibility (therapeutic CPAP values ≤ 8 cm H(2)O) was present in 25.3% of patients. They showed more favorable apnea-hypopnea index, oxygen desaturation index, mean nocturnal saturation, sleep time with oxygen saturation < 90%, desaturation nadir, and supine position. Oxygen desaturation index showed a weak association with anatomical collapsibility. Using the receiver operating characteristic curve, the area under the curve for the oxygen desaturation index vs CPAP pressure requirements ≤ 8 cm H(2)O was low and oxygen desaturation index ≤ 40.8/h showed a sensitivity of 63.3% and a specificity of 69.2% to detect patients with mild collapsibility. CONCLUSIONS: A quarter of moderate to severe patients under CPAP therapy had mild collapsibility and were likely to also be good candidates for alternative and better tolerated non-CPAP therapies. Baseline anthropometric, clinical, and respiratory function characteristics did not predict mild upper airway collapsibility determined by CPAP pressure requirements ≤ 8 cm H(2)O. CITATION: Bosi M, Incerti Parenti S, Fiordelli A, Poletti V, Alessandri-Bonetti A. Upper airway collapsibility in patients with OSA treated with continuous positive airway pressure: a retrospective preliminary study. 2020;16(11):1839–1846. |
| Databáze: | OpenAIRE |
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