Determinants of the changes in positive airway pressure for the retitration in patients with obstructive sleep apnea syn
- PDF / 722,368 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 59 Downloads / 164 Views
ORIGINAL ARTICLE
Determinants of the changes in positive airway pressure for the retitration in patients with obstructive sleep apnea syndrome Gulcin Benbir Senel1 · Pinar Bekdik Sirinocak1 · Derya Karadeniz1 Received: 10 March 2020 / Accepted: 2 June 2020 © Japanese Society of Sleep Research 2020
Abstract During long-term follow-up of the patients with obstructive sleep apnea syndrome (OSAS) under the positive airway pressure (PAP) therapy, it waits to be explored whether or when routine retitrations are indicated. We prospectively followed up 133 patients for 10 years to define which demographical or polysomnographic factors should be taken into account to determine the need for retitration. Patients were retitrated at 1st, 2nd, 5th, and 10th follow-up years. A change in pressures ≥ 2cmH2O was present in more than half of the patients at 2nd and 5th years. Changes in weight for at least 10 kg showed a significant correlation with the changes in pressures ≥ 2cmH2O (p = 0.023) and ≥ 3cmH2O (p = 0.047) at 2nd year. OSAS-related complaints, nasal or upper airway surgery, or emergence of cardiovascular diseases were not correlated with the changes in pressures. Apnea–hypopnea index (AHI) at diagnostic night was positively correlated with the changes in pressures ≥ 3cmH2O at 1st and 5th years. The percentage of N3 sleep at first titration night showed positive correlation with changes in pressures ≥ 3cmH2O at 2nd and 5th years. The index of periodic leg movements in sleep (PLMS) and PLMS-arousal index at first titration night was positively correlated with any change in pressures at 2nd and 5th years. Our findings showed that vast changes in weight, high AHI at diagnostic night, increased duration of deep NREM sleep and high PLMS and PLMS-arousal indices at first titration night should be noted as important indicators for retitration within the first 5 years of follow-up. Keywords Obstructive sleep apnea syndrome · Positive airway pressure · Retitration
Introduction The gold standard treatment of the obstructive sleep apnea syndrome (OSAS) is well known as the positive airway pressure (PAP) therapy [1, 2], which was first described by Sullivan in 1981 [3], and proven to keep the upper airways open, eliminating the abnormal respiratory events. An efficient PAP therapy not only eliminates the complaints of the patients, maintains stable oxygenation, and preserves the micro- and macro-structure of sleep, but also protects the patients from OSAS-related complications such as hypertension, ischemic heart diseases, and cerebrovascular diseases A part of this study was presented as an oral presentation in the 15th Turkish Sleep Medicine Congress in 2014 (SB-26). * Gulcin Benbir Senel [email protected] 1
Sleep and Disorders Unit, Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul UniversityCerrahpasa, Istanbul 34098, Turkey
[4, 5]. It is, therefore, crucial to determine the most effective pressure settings, together with appropriate supportive approaches to increase the compliance to PAP therap
Data Loading...
