Risk factors for failure of continuous positive airway pressure treatment in patients with ostructive sleep apnoea
Jazyk angličtina Země Česko Médium print-electronic
Typ dokumentu časopisecké články, pozorovací studie
PubMed
29358787
DOI
10.5507/bp.2017.056
Knihovny.cz E-zdroje
- Klíčová slova
- BMI, CPAP failure, obesity, prediction, sleep apnoea syndrome,
- MeSH
- index tělesné hmotnosti MeSH
- lidé středního věku MeSH
- lidé MeSH
- neúspěšná terapie MeSH
- obezita komplikace MeSH
- obstrukční spánková apnoe komplikace terapie MeSH
- plocha pod křivkou MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- ROC křivka MeSH
- trvalý přetlak v dýchacích cestách * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
BACKGROUND AND AIMS: Obstructive sleep apnoea is a potentially serious sleep disorder associated with the risk of cardiovascular disease. It is treated with continuous airway pressure (CPAP) but this is not always successful. Unsuccessful cases should be treated by bilevel positive airway pressure (BiPAP). The aim of this study was to determine whether common respiratory parameters and/or body mass index (BMI) can be used to predict the probability CPAP failure and hence start such patients on BiPAP from the outset. METHODS: A sample of patients treated by CPAP for OSAS was evaluated a retrospective cohort study. The data measured in sleep monitoring of the successfully treated group and of the group where CPAP had failed were compared. Subsequently, the predictive abilities of BMI, Apnoea Index (AI), Apnoea-Hypopnea Index (AHI), percentage of sleep time in less than 90% oxygen saturation (T90), average oxygen saturation over the duration of sleep (SaO2) and average desaturation per hour of sleep (ODI) were assessed with respect to CPAP failure, both individually and in combination. RESULTS: A sample of 479 patients was included in the study. All of the recorded variables except AI were significantly associated with failure of CPAP and their ability to predict the failure ranged from poor to moderate. Since there was significant correlation among all the variables measured a two-variable prediction model combining T90 and BMI produced no significant improvement in the quality of CPAP failure prediction. CONCLUSIONS: BMI was a significant predictor of CPAP failure although it was slightly less predictive than T90. The set of monitored variables included in our study does not allow for CPAP failure to be predicted with clinically relevant reliability.
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