Document Detail

Multinight recording and analysis of continuous positive airway pressure airflow in the home for titration and management of sleep disordered breathing.
MedLine Citation:
PMID:  23543909     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The authors examined magnitude/variability of residual sleep disordered breathing (SDB) at pressures around the therapeutic continuous positive airway pressure (CPAP), and described a multinight approach to CPAP titration/retitration consisting of recording airflow and summarizing SDB over multiple nights at multiple pressures and choosing an optimal pressure from these summarized data.
DESIGN: Prospective, single-center nonblinded study.
PATIENTS: Ten female/18 male patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) (respiratory disturbance index [RDI] 67/h), 17 newly-initiated, 11 chronic CPAP users.
INTERVENTIONS: A custom CPAP device (Fisher & Paykel Healthcare) recording airflow and pre-programmed to vary CPAP between 2-3 cm H2O below and 1-2 cm H2O above prescription pressure as determined by a full laboratory titration.
RESULTS: Airflow and pressure continuously recorded for multiple nights (15.9 ± 5.1 nights) at four to seven different pressures in each patient. SDB events manually scored from the airflow as apnea (airflow reduction > 90%), hypopnea (airflow reduction > 30% lasting 10 to 120 sec with inspira-tory flow limitation [IFL]) and runs of sustained IFL > 2 min identified. RDI = (apnea + hypopnea)/total sleep time calculated for each night and an obstruction index, including sustained IFL, also was calculated. PressureMultinight was obtained for each patient from multiple nights of data using two mathematical techniques. Night-to-night variability of SDB indices was low in some patients and significant in others. PressureMultinight could be determined in 17 of 28 patients and was similar to the in-laboratory pressure.
CONCLUSIONS: This study showed that recording multiple nights of CPAP airflow in the home and analyzing these data for residual SDB provided useful information, including the possibility of determining a therapeutic prescription for fixed CPAP in most patients and identification of others with significant physiologic variability of SDB.
Cynthia Y Callahan; Robert G Norman; Zachary Taxin; Anne M Mooney; David M Rapoport; Indu Ayappa
Related Documents :
1095159 - A method for prevention of cardiovascular reactions to laryngoscopy and intubation.
7547039 - Volume preloading is not essential to prevent spinal-induced hypotension at caesarean s...
1501209 - Tiletamine hydrochloride in combination with zolazepam hydrochloride as an anaesthetic ...
19577409 - Bis response to tamponade and dobutamine in swine varies with hypnotic/opiate ratio.
23612619 - Comparison of haemodynamic effects of noninvasive ventilation delivered via resqgard an...
12939509 - Clinical observations during induction and recovery of xylazine-midazolam- propofol ane...
7243089 - Uterine contraction intervals and transcutaneous levels of fetal oxygen pressure.
6139019 - Pharmacologic and physiologic considerations of adrenoceptor blockade.
14715359 - Comparison of effects on left ventricular filling pressure of intravenous nesiritide an...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-04-01
Journal Detail:
Title:  Sleep     Volume:  36     ISSN:  1550-9109     ISO Abbreviation:  Sleep     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-01     Completed Date:  2013-09-30     Revised Date:  2013-10-08    
Medline Journal Info:
Nlm Unique ID:  7809084     Medline TA:  Sleep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  535-545F     Citation Subset:  IM    
NYU School of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York, NY, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Continuous Positive Airway Pressure / methods*,  statistics & numerical data
Disease Management
Feasibility Studies
Middle Aged
Patient Compliance / statistics & numerical data*
Polysomnography / methods*,  statistics & numerical data
Prospective Studies
Reproducibility of Results
Sleep Apnea Syndromes / therapy*
Grant Support
Comment In:
Sleep. 2013 Apr;36(4):463-4   [PMID:  23559689 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Safety of Anti-Diabetic Therapies on Bone.
Next Document:  Using Logic Analysis to Evaluate Knowledge Transfer Initiatives: The Case of the Research Collective...