Optimal Continuous Positive Airway Pressure Level in Korean Patients with Obstructive Sleep Apnea Syndrome
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives. The aim of this study was to investigate optimal continuous positive airway pressure (CPAP) level, to examine the factors affecting optimal CPAP level, and to develop a predictive equation for optimal CPAP level in Korean patients with obstructive sleep apnea syndrome (OSAS). Methods. A total of 202 patients with OSAS who underwent successful manual titration for CPAP treatment were included in this study. Correlations between the optimal CPAP level and baseline data including anthropometric and polysomnographic variables were analyzed. A predictive equation for optimal CPAP level was developed based on anthropometric and polysomonographic data. Results. The mean optimal CPAP level in 202 patients with OSAS was 7.8±2.3 cm H2O. The mean optimal CPAP level in the mild, moderate, and severe OSAS groups was 6.0±1.3, 7.4±1.9, and 9.1±2.1 cm H2O, respectively. The apneahypopnea index (AHI) (r=0.595, P<0.001), arousal index (r=0.542, P<0.001), minimal SaO2 (r=-0.502, P<0.001),body mass index (BMI) (r=0.494, P<0.001), neck circumference (r=0.265, P<0.001), and age (r=-0.164, P=0.019)were significantly correlated with optimal CPAP level. The best predictive equation according to stepwise multiple linear regression analysis was: Optimal CPAP level (cm H2O)=0.681+(0.205×BMI)+(0.040×AHI). Forty-two percent of the variance in the optimal CPAP level was explained by this equation (R2=0.42, P<0.001). Conclusion. A predictive equation for optimal CPAP level in Korean patients with OSAS was developed using AHI and BMI, which can be easily measured during the diagnostic process.
Abstract
Objectives. The aim of this study was to investigate optimal continuous positive airway pressure (CPAP) level, to examine the factors affecting optimal CPAP level, and to develop a predictive equation for optimal CPAP level in Korean patients with obstructive sleep apnea syndrome (OSAS). Methods. A total of 202 patients with OSAS who underwent successful manual titration for CPAP treatment were included in this study. Correlations between the optimal CPAP level and baseline data including anthropometric and polysomnographic variables were analyzed. A predictive equation for optimal CPAP level was developed based on anthropometric and polysomonographic data. Results. The mean optimal CPAP level in 202 patients with OSAS was 7.8±2.3 cm H2O. The mean optimal CPAP level in the mild, moderate, and severe OSAS groups was 6.0±1.3, 7.4±1.9, and 9.1±2.1 cm H2O, respectively. The apneahypopnea index (AHI) (r=0.595, P<0.001), arousal index (r=0.542, P<0.001), minimal SaO2 (r=-0.502, P<0.001),body mass index (BMI) (r=0.494, P<0.001), neck circumference (r=0.265, P<0.001), and age (r=-0.164, P=0.019)were significantly correlated with optimal CPAP level. The best predictive equation according to stepwise multiple linear regression analysis was: Optimal CPAP level (cm H2O)=0.681+(0.205×BMI)+(0.040×AHI). Forty-two percent of the variance in the optimal CPAP level was explained by this equation (R2=0.42, P<0.001). Conclusion. A predictive equation for optimal CPAP level in Korean patients with OSAS was developed using AHI and BMI, which can be easily measured during the diagnostic process.
참고문헌 (26)
- Epstein LJ, "Clinical guideline for the evaluation,management and longterm care of obstructive sleep apnea in adults", J Clin Sleep Med, 5(3), pp.263~276 (2009)
- Kim J, "Prevalence of sleepdisordered breathing in middle-aged Korean men and women", Am J Respir Crit Care Med, 170(10), pp.1108~1113 (2004)
- Nelson B. Powell, "Contemporary Surgery for Obstructive Sleep Apnea Syndrome", Clinical and Experimental Otorhinolaryngology, 2(3), pp.107~114 (2009), 대한이비인후과학회
- Sullivan CE, "Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares", Lancet, 1(8225), pp.862~865 (1981)
- 김지희, "Compliance with Positive Airway Pressure Treatment for Obstructive Sleep Apnea", Clinical and Experimental Otorhinolaryngology, 2(2), pp.90~96 (2009), 대한이비인후과학회
- Kushida CA, "parameters for the treatment of snoring and Obstructive Sleep Apnea with oral appliances:an update for 2005", Sleep, 29(2), pp.240~243 (2006)
- Morgenthaler TI, "Practice parameters for the medical therapy of obstructive sleep apnea", Sleep, 29(8), pp.1031~1035 (2006)
- Choi JH, "Efficacy study of a vest-type device for positional therapy in position dependent snorers", Sleep Biol Rhythms, 7(3), pp.181~187 (2009)
- Kushida CA, "Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders", Sleep, 29(3), pp.375~380 (2006)
- Ballester E, "Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea", hypopnea syndrome, 1999, pp.159(2), 495~501
- Jenkinson C, "Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea:a randomised prospective parallel trial", Lancet, 353(9170), pp.2100~2105 (1999)
- Kakkar RK, "Positive airway pressure treatment for obstructive sleep apnea", Chest, 132(3), pp.1057~1072 (2007)
- Morgenthaler TI, "Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome:an update for 2007. An American Academy of Sleep Medicine report", Sleep, 31(1), pp.141~147 (2008)
- Miljeteig H, "Determinants of continuous positive airway pressure level for treatment of obstructive sleep apnea", Am Rev Respir Dis, 147(6 Pt 1), pp.1526~1530 (1993)
- Sforza E, "Pharyngeal critical pressure in patients with obstructive sleep apnea syndrome.Clinical implications", Am J Respir Crit Care Med, 159(1), pp.149~157 (1999)
- Akashiba T, "Optimal continuous positive airway pressure in patients with obstructive sleep apnoea:role of craniofacial structure", Respir Med, 95(5), pp.393~397 (2001)
- Lin IF, "Predicting effective continuous positive airway pressure in Taiwanese patients with obstructive sleep apnea syndrome", J Formos Med Assoc, 102(4), pp.215~221 (2003)
- Stradling JR, "Relative accuracy of algorithm-based prescription of nasal CPAP in OSA", Respir Med, 98(2), pp.152~154 (2004)
- Loredo JS, "Prediction of continuous positive airway pressure in obstructive sleep apnea", Sleep Breath, 11(1), pp.45~51 (2007)
- Akahoshi T, "Predicting optimal continuous positive airway pressure in Japanese patients with obstructive sleep apnoea syndrome", Respirology, 14(2), pp.245~250 (2009)
- Rowley JA, "The use of a predicted CPAP equation improves CPAP titration success", Sleep Breath, 9(1), pp.26~32 (2005)
- Fitzpatrick MF, "Can patients with obstructive sleep apnea titrate their own continuous positive airway pressure?", Am J Respir Crit Care Med, 167(5), pp.716~722 (2003)
- Masa JF, "lternative methods of titrating continuous positive airway pressure: a large multicenter study", Am J Respir Crit Care Med, 170(11), pp.1218~1224 (2004)
- Kushida CA, "Practice parameters for the indications for polysomnography and related procedures: an update for 2005", Sleep, 28(4), pp.499~521 (2005)
- Rechtschaffen A, "A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects", U. S. National Institute of Neurological Diseases and Blindness, Neurological Information Network, ~ (1968)
- "EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association", Sleep, 15(2), pp.173~184 (1992)
