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

Camacho, Macario; Riaz, Muhammad Bilal; Tahoori, Armin; Certal, Victor; Kushida, Clete A.

doi:10.1155/2015/293868

Cited by 37 publications

(55 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most recent Cochrane reviews however found no statistically significant difference between the various available appliances (28,29). Research continues in predicting CPAP pressure requirements and many parameters have been suggested including BMI, mean oxygen saturation, mean respiratory disturbance index, gender, depression and mask leak-with the strongest mathematical weighting for BMI and mean oxygen saturation (30)(31)(32)(33).…”

Section: Application Modifications and Patient Interventionsmentioning

confidence: 99%

When continuous positive airway pressure (CPAP) fails

Virk¹,

Kotecha²

2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Obstructive sleep apnoea (OSA) is increasingly prevalent, particularly in the context of the obesity epidemic, and is associated with a significant social, health and economic impact. The gold standard of treatment for moderate to severe OSA is continuous positive airway pressure (CPAP). However compliance rates can be low. Methodology to improve patient tolerance to CPAP alongside with alternative, non-surgical and surgical, management strategies are discussed. All patients that fail CPAP therapy would benefit from formal upper airway evaluation by the otolaryngologist to identify any obvious causes and consider site-specific surgical therapies. Patient selection is integral to ensuring successful outcomes. A multidisciplinary team is needed to manage these patients.

show abstract

Section: Application Modifications and Patient Interventionsmentioning

confidence: 99%

When continuous positive airway pressure (CPAP) fails

Virk¹,

Kotecha²

2016

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…Our results were in concordance with more severe OSA and lower SaO 2 during NREM sleep. Camacho et al in their systematic review of 26 studies on mathematical equations of CPAP prediction, reported BMI and mean oxygen saturation as the most heavily weighted variables along with BMI, AHI, and neck circumference as the most frequently used variables (Camacho et al, 2015). The likelihood of changing from CPAP to BiPAP was almost doubled by higher BMI and neck circumference in our study population.…”

Section: Discussionmentioning

confidence: 52%

“…Many formulas derived from clinical and para-clinical variables have been developed to predict the optimal PAP. Oxygen desaturation, Apnea Hypopnea Index, and neck circumference are considered to be the main predictive factors for the prediction of CPAP pressure in the body of related literature (Abdel Wahab & Ahmed, 2017;Camacho, Riaz, Tahoori, Certal, & Kushida, 2015;Ebben, Narizhnaya, & Krieger, 2017;Noseda et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Useful variables during wake and sleep for prediction of positive airway pressure in obstructive sleep apnea titration

Setareh

Malekmohammad

Amini

et al. 2019

Sleep Science Practice

View full text Add to dashboard Cite

Background: Positive airway pressure is the main treatment modality in obstructive sleep apnea. The level of pressure needed for each patient is defined by a positive airway pressure titration study. Predicting those who need higher pressure or bi-level instead of continuous pressure is of a great clinical significance. This study was designed to evaluate whether voluntary breath-holding maneuver could predict Bilevel Positive Airway Pressure (BiPAP) or Continuous Positive Airway Pressure (CPAP) as the final optimal pressure in a split night study of patients with obstructive sleep apnea. Polysomnography (PSG) parameters specially oxygen saturation (SaO 2 ) during non-rapid eye movement (NREM), rapid eye movement sleep (REM), and duration of REM in diagnostic part may help determine the type of devices as soon as possible in split night study. Methods: The present research was conducted as a cross-sectional study of adults diagnosed as obstructive sleep apnea patients undergoing positive airway pressure (PAP) titration. Demographic, anthropometric, and polysomnographic data were collected. Patients were instructed to hold their breath as long as they could after five tidal breaths in the supine position. Baseline, post breath-holding phase, and recovery SaO 2 were recorded. These data were used to predict the pressure level and type of device. Results: Seventy-eight participants (56.4% male) with the mean age of 55.7 ± 13.9 years were included in the study. Mean and SD of apnea hypopnea index (AHI) and oxygen desaturation index (ODI) were 55.9 ± 34.4 and 38.3 ± 24 per hour, respectively. Most of the participants (65.3%) were categorized as CPAP group. CPAP and BiPAP groups were similar in terms of age, gender distribution, body mass index (BMI), neck circumference, and certain polysomnographic variables. Voluntary breath-holding maneuver showed a significant correlation between minimum SaO 2 and the need for changing to BiPAP during titration. Baseline and post breath-holding SaO 2 were not significantly lower in either group. NREM minimum SaO 2 and REM duration were the statistically significant correlated variables that predicted the need for BiPAP. Conclusion: Minimum oxygen following voluntary breath-holding maneuver along with higher BMI and larger neck circumference are predictors of the need to use BiPAP. Shorter REM duration and NREM minimum SaO 2 were other predictors of higher chance of BiPAP during titration of the present OSA participants.

show abstract

“…Our previous study of 358 snoring patients also found that NP narrowing, UAL, and MPH seem to play important physiopathogenic roles in OSA [6]. Some studies have reported that any obstruction of the upper airway would have an effect on CPAP titration level by interfering with the airflow [10][11][12], with a consequential impact on CPAP compliance.…”

Section: Discussionmentioning

confidence: 87%

“…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. Bosi et al [11] reported that PSG variables and anthropometric parameters had no significant independent predictive value for CPAP titration, with the exception of BMI.…”

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

View full text Add to dashboard Cite

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.

show abstract

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

Cited by 37 publications

References 68 publications

When continuous positive airway pressure (CPAP) fails

When continuous positive airway pressure (CPAP) fails

Useful variables during wake and sleep for prediction of positive airway pressure in obstructive sleep apnea titration

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

Contact Info

Product

Resources

About