Long-term positive airway pressure therapy is associated with reduced total cholesterol levels in patients with obstructive sleep apnea: data from the European Sleep Apnea Database (ESADA)
Canan GündüzÖzen K. BaşoğluJohn A. KvammeJohan VerbraeckenUlla AnttalainenOreste MarronePaschalis SteiropoulosG. RoismanPavol JoppaHolger HeinGeorgia TrakadaJan HednerLudger GrotePaschalis SteiropoulosJohan VerbraeckenE. PetietGeorgia TrakadaJosep M. MontserratIngo FietzeThomas PenzelOndřej LudkaDaniel RodensteinJuan F. MasaIzolde BouloukakiSophia SchizaBrian D. KentW.T. McNicholasStephen J. RyanR.L. RihaJ.A. KvammeHolger HeinRichard SchulzLudger GroteJan HednerDing ZouJean‐Louis PépinPatrick LévySébastien BaillyLena LaviePeretz LavieÖzen K. BaşoğluMehmet Sezai TaşbakanGiedrius VaroneckasPavol JoppaR TkácováRichard StaatsFerrán BarbéCarolina LombardiGianfranco ParatiMarta DrummondMafalda van ZellerMaria R. BonsignoreOreste MarroneMichel PetitjeanG. RoismanMartin PretlA. VitolsZoran ĐogašTea GalićAthanasia PatakaUlla AnttalainenTarja SaaresrantaRobert PływaczewskiP SliwińskiPiotr Bielicki
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Dyslipidemia
Positive airway pressure
Nocturnal muscle activity in legs (MAL) was studied in 19 patients with sleep apnea syndrome before and during nCPAP. We distinguished periodic (P-MAL) and nonperiodic (N-MAL) as well as apnea-associated and independent MALs. N-MALs were strongly associated with apneas and disappeared during nasal continuous positive airway pressure (nCPAP). P-MALs showed a rather long intermovement interval (IMI) of about 54 s when associated with respiratory disturbances and a shorter one of about 38 s when occurring independently. In 5 patients with predominantly independent P-MALs and a short IMI before and during nCPAP an incidental coexistence of sleep apnea with periodic leg movements in sleep syndrome (PLMS) was postulated. Five patients with an equal number of apnea-associated and independent MALs before nCPAP had a long IMI which shortened under nCPAP, while the majority of MALs become independent. This could indicate a facilitating or an unmasking effect of nCPAP on PLMS. Four patients with predominantly apnea-associated MALs with a long IMI before nCPAP showed an unchanged MAL pattern under nCPAP, despite the disappearance of apneas. Since some arousals persisted in these patients, insufficient nCPAP pressure with an upper airway resistance syndrome was suspected. We conclude that when P-MALs persist under nCPAP therapy a long IMI may indicate an upper airway resistance syndrome, whereas a short IMI may indicate a coexisting or even induced PLMS.
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Apnea of prematurity
Airway obstruction
Positive pressure
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Aim To investigate whether Bi‐level positive airway pressure (BiPAP), compared with nasal continuous positive airway pressure (CPAP), is a more effective therapeutic strategy in preterm infants ≤32 weeks. Methods All inborn infants between 26 +1 and 32 +6 weeks' gestation, admitted to the neonatal intensive care unit (NICU ) of Tongji Medical Hospital between 1 January, 2010 and 31 December, 2011 (the 2010–2011 cohort or CPAP cohort) and between 1 January, 2012 and 31 December, 2013 (the 2012–2013 cohort or BiPAP cohort), were retrospectively identified. The primary outcome was intubation in infants < 72 h of age; secondary outcomes were mortality and the incidence of bronchopulmonary dysplasia (BPD). Results There were 213 in the 2010–2011 cohort and 243 infants in the 2012–2013 cohort. There were fewer infants intubated within the first 72 h of age in the 2012–2013 cohort than in the 2010–2011 cohort (15% vs. 23%, P < 0.05). Of the infants who received some form of positive airway pressure, 12/94 (13%) of infants on BiPAP versus 23/74 (31%) on CPAP were subsequently intubated ( P < 0.01). There was no difference in the incidence of moderate and severe BPD between the two groups (7% vs. 8%, P =0.52). Conclusions In this retrospective cohort study, we found BiPAP, compared with CPAP, reduced the need for intubation within the first 72 h of age.
Bronchopulmonary Dysplasia
Positive airway pressure
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Objective Of continuous positive airway pressure(CPAP) for the treatment of neonatal apnea effects of repeated. Methods Observed before and after CPAP treatment changes in the number of apnea episodes and the changes in blood gas before and after treatment to determine efficacy. Results As a result of the original incidence varied in different effects,with a total effective rate of 80%. After treatment,pH and PaO2 significantly increased,the partial pressure of carbon dioxide had no significant change(P ＞0.05). Conclusion CPAP treatment of neonatal apnea repeatedly significant,it is worth at all levels to promote the use of the hospital.
Key words:
Apnea; Newborn; Continuous positive airway pressure; Blood gas analysis
Positive airway pressure
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In this work, a method to analyse the effects of an apnea on the pulse photopletismography signal (PPG) is proposed. Therefore, an apnea detector based on respiratory signals has been developed and a decreases in amplitude of PPG (DAP) detector developed in a previous study was used. The apnea detector was tested using real signals. S and +PV of the detector were 95.3% and 94.4%, respectively. For each of the apneic events, we analyzed the presence of DAP in a window previous to the apnea event and another during/following the apnea. An increase of about 15% in DAP events in the window during/following the apnea with respect to the previous to apnea window is produced. These results shows an association between apneic events and DAP events, which indicates that DAP events provide useful information in sleep research and PPG signals might be useful in the diagnosis of OSAS
SIGNAL (programming language)
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Positive airway pressure
Bronchopulmonary Dysplasia
Necrotizing Enterocolitis
Positive pressure
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Positive airway pressure
Positive pressure
Constant (computer programming)
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Positive pressure
Central sleep apnea
Sleep
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OBJECTIVES Continuous positive airway pressure (CPAP) improves sleep apnea survival. We tested whether CPAP is associated with better survival than uvulopalatopharyngoplasty (UPPP). STUDY DESIGN AND METHODS This retrospective cohort database study included all sleep apnea patients treated with CPAP or UPPP in Veteran Affairs facilities from October 1997 through September 2001. Treatment groups were compared with Cox regression, adjusting for age, gender, race, year treatment was initiated, and comorbidity. Sleep apnea severity and CPAP use data were not available. RESULTS By September 2002, 1339 (7.1%) of 18, 754 CPAP patients and 71 (3.4%) of 2,072 UPPP patients were dead ( P < 0.001). After adjustment, CPAP patients had 31% (95% confidence interval, 3% to 67%, P = 0.03) higher probability of being dead at any time, relative to UPPP patients. CONCLUSIONS UPPP confers a survival advantage over CPAP, after adjustment for age, gender, race, year of treatment, and comorbidity. However, we were unable to adjust for sleep apnea severity or CPAP use. Surgical treatment should be considered in sleep apnea patients who use CPAP inadequately. (Otolaryngol Head Neck Surg 2004;130: 659‐65.)
Uvulopalatopharyngoplasty
Hypercarbia
Positive airway pressure
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INTRODUCTION: The Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a risk factor for bariatric surgery. There aren´t clear risk factors to identify subpopulations at risk.
OBJECTIVES: Correlate clinical data and OSAHS in candidates for obesity surgery, using home sleep study.
METHODS: 53 sequential candidates for obesity surgery (BMI> 33), without diagnosis of OSAHS. It was recorded: Mallampati score (MS), neck circumference (NC), chin-sternum distance (CSD) and apnea and hypopnea index (AHI - measured by ApneaLink Plus ®). The apnea, as AHI, was classified as: absent ( 30).
RESULTS: 43 women (81%) and 10 males (19%), with medium age of 38 years. Apnea was founded in 31 (58%) patients: mild in 17 (32%), moderate in 8 (19%) and severe in 6 (11%). The greater AHI was 115, and 4 had an AHI > 50. Of the 6 patients with severe apnea, 5 (83.33%) were male. In moderate apnea, 6 (75%) were female and in mild, 16 (94%). In severe apnea, the lowest BMI was 44. At moderate apnea, 80% were classified in grade III (BMI> 40). For MS, of the 44 patients with MS III or IV, 30 (68%) had apnea; , 4 (25%) of 20 patients with MS IV had severe sleep apnea and 6 (30%) had no apnea. For NC, 100% of patients with severe apnea had CC> 40, whereas only 41% of patients with mild apnea had this feature. The CSD had no correlation with AHI. The NC/CSD ratio ≥2.5 identified 77% (17/25) of OSAHS patients and 71% (10/14) of patients with moderate OSAHS.
CONCLUSIONS: Positive correlation with male gender and BMI> 44 was found. NC> 40 and the NC/CSD ratio > 2.5 ratio was associated with moderate or severe OSAHS. The portable monitoring was a reliable tool for this screening.
Hypopnea
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