Clinical predictors of effective continuous positive airway pressure in patients with obstructive sleep apnea/hypopnea syndrome

Lai, Chien Hung; Friedman, Michael; Lin, Hsin‐Ching; Wang, Pa‐Chun; Hwang, Michelle S.; Hsu, Cheng‐Ming; Lin, Meng‐Chih; Chin, Chien-Hung

doi:10.1002/lary.25125

Cited by 24 publications

(23 citation statements)

References 16 publications

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“…have found that the obstruction at tongue base level may predict the level of optimal CPAP pressure required for the patient. 11 In our study, we found that a CPAP pressure of 15 cm H 2 O was effective for treating tongue base collapse and increasing airway volume within the retrolingual region (Figure 2, Video 2).…”

Section: Discussionmentioning

confidence: 58%

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug‐induced sleep endoscopy

Torre

Liu

Kushida

et al. 2017

Clinical Otolaryngology

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The differential nCPAP effects observed in this study may help to understand some of the mechanisms responsible for inadequate patient response and poor nCPAP compliance. The use of DISE in combination with CPAP may serve as a first step in optimizing patients that failed to adapt to treatment with CPAP. This approach can help the physician identify patterns of airway collapse that may require varying pressures different from the one the patient is using, as well as anatomical factors that may be corrected to help with compliance.

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Section: Discussionmentioning

confidence: 58%

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug‐induced sleep endoscopy

Torre

Liu

Kushida

et al. 2017

Clinical Otolaryngology

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“…There were 4,436 patients in the development phases and 3,489 patients in the validation phases for the combined studies included in this review. The earliest published study was by Miljeteig and Hoffstein [ 38 ] in 1993 and the most recent study was published in 2015 [ 56 ]. Table 1 presents the study quality assessment for the individual studies.…”

Section: Resultsmentioning

confidence: 99%

“…Additional Variables . The updated Friedman Tongue Position was a variable in the study by Lai et al [ 56 ]. Smoking in pack years was a variable in the formulas derived by Schiza et al [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

“…Second, polysomnographic variables were also important during the multiple linear regressions analyses. Apnea-hypopnea index was a variable in mathematical equations for seventeen studies [ 13 , 20 , 32 , 35 , 38 , 43 – 45 , 56 – 60 , 64 , 66 ] and RDI for four studies [ 31 , 34 , 55 , 65 ]. The coefficient for AHI ranged between 0.01 and 0.18 and for RDI ranged between 0.01301 and 0.041.…”

Section: Discussionmentioning

confidence: 99%

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Mathematical Equations to Predict Positive Airway Pressures for Obstructive Sleep Apnea: A Systematic Review

et al. 2015

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Objective. To systematically review the international literature for mathematical equations used to predict effective pressures for positive airway pressure (PAP) devices. Methods. Google Scholar, PubMed, Scopus, Embase, Web of Science, CINAHL, and The Cochrane Library were searched through June 27, 2015. The PRISMA statement was followed. There was no language limitation. Results. 709 articles were screened, fifty were downloaded, and twenty-six studies presented equations that met the inclusion and exclusion criteria. In total, there were 4,436 patients in the development phases and 3,489 patients in the validation phases. Studies performed multiple linear regressions analyses as part of the equation(s) development and included the following variables: physical characteristics, polysomnography data, behavioral characteristics, and miscellaneous characteristics, which were all predictive to a variable extent. Of the published variables, body mass index (BMI) and mean oxygen saturation are the most heavily weighted, while BMI (eighteen studies), apnea-hypopnea index (seventeen studies), and neck circumference (eleven studies) were the variables most frequently used in the mathematical equations. Ten studies were from Asian countries and sixteen were from non-Asian countries. Conclusion. This systematic review identified twenty-six unique studies reporting mathematical equations which are summarized. Overall, BMI and mean oxygen saturation are the most heavily weighted.

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“…Previous research evaluating the possible influential factors in CPAP titration, aimed at lowering economic costs and significantly increasing the tolerance of CPAP therapy, have produced varying results [10,13,14]. A systematic review by Camacho et al [10] showed that BMI and ODI weighed most heavily in the equation that predicted the CPAP titration level.…”

Section: Discussionmentioning

confidence: 99%

Impact of upper airway configuration assessed by CT on CPAP titration in OSA patients during Müller's maneuver

Lin

Xie

Huang

et al. 2019

Preprint

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Objectives Continuous positive airway pressure (CPAP) is the current gold-standard treatment for moderate to severe obstructive sleep apnea (OSA), and upper airway anatomy plays an increasingly important role in evaluating the efficacy of CPAP therapy. The aim of this observational study was to investigate the influence of upper airway anatomy on CPAP titration in OSA patients assessed by computed tomography (CT) during Müller's maneuver. Methods Consecutive patients under investigation for OSA by undergoing polysomnography and CT scan of the upper airway while awake were enrolled. Successful full-night manual titration was performed to determine the optimal CPAP pressure level for OSA patients in supine position using a nasal mask. Results A total of 157 subjects (134 males and 23 females) were included. Both apnea–hypopnea index (AHI) and LaSO2 significantly correlated with CPAP titration level, upper airway length (UAL), distance from mandibular plane to hyoid bone (MPH), and neck circumference (all p<0.05). There were significant positive correlations between CPAP titration level and UAL (r=0.348, p=0.000) and MPH (r=0.313, p=0.002). Stepwise multiple linear regression analyses were performed to evaluate the independent predictors of AHI, LaSO2, and CPAP titration level. CPAP titration level was identified as an independent explanatory variable for AHI and LaSO2 after adjustment for confounders. Multiple linear regression analyses also indicated that body mass index (BMI) and UAL were independently associated with CPAP titration level (all p<0.05). Conclusions Upper airway abnormalities combined with anthropometric parameters play important roles in CPAP titration for OSA patients, providing additional insight into the factors influencing OSA treatment strategies. UAL and BMI should be taken into consideration when choosing CPAP titration level to improve CPAP compliance.

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Clinical predictors of effective continuous positive airway pressure in patients with obstructive sleep apnea/hypopnea syndrome

Abstract: 4.

Cited by 24 publications

References 16 publications

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug‐induced sleep endoscopy

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug‐induced sleep endoscopy

Mathematical Equations to Predict Positive Airway Pressures for Obstructive Sleep Apnea: A Systematic Review

Impact of upper airway configuration assessed by CT on CPAP titration in OSA patients during Müller's maneuver

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