Document Detail


Obstructive pressure peak: a new method for differentiation of obstructive and central apneas under auto-CPAP therapy.
MedLine Citation:
PMID:  22302201     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Auto-CPAP devices (APAP) are controlled, e.g., by the respiratory flow and pressure to adjust the treatment pressure to the variable obstruction in sleep apnea syndromes. By obstruction of the upper airway during inspiration, a pressure difference between the lower airways and the mask can be measured. In case of an opening of the pharynx at the end of the obstruction, the pressure decreases immediately. This brief negative pressure, the so-called obstructive pressure peak (OPP) can be used to identify obstruction or open airways with the algorithm of an APAP device. Useless pressure increases, e.g., after central apneas without obstruction may be avoided. We therefore investigated the association of the OPP signal with respiratory events during APAP therapy. METHODS: In this pilot study, 13 patients with obstructive sleep apnea syndrome were evaluated. Attended automatic CPAP titration (SOMNObalance, Fa Weinmann Hamburg/Germany) was performed. The OPP signal was recorded synchronously in parallel with the polysomnographic data. If the OPP signal was within a time range of ±5 s of the resumption of normal breathing, it was assigned to the event. RESULTS: A total of 480 sleep-related breathing disorders events were studied. The most common were the mixed apneas associated with more than 90% of all cases with an OPP signal, followed by obstructive sleep apneas (66.7%) and central apneas (38%). The difference in OPP frequency distribution between central apneas and obstructive apneas was significant with p < 0.001. CONCLUSIONS: The analysis of the pressure characteristics of APAP treatment with the registration of OPP allows a further differentiation in obstructed and not obstructed upper airways.
Authors:
K H Ruhle; U Domanski; G Nilius
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-2
Journal Detail:
Title:  Sleep & breathing = Schlaf & Atmung     Volume:  -     ISSN:  1522-1709     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804161     Medline TA:  Sleep Breath     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pneumology, HELIOS Clinic Ambrock, Ambrockerweg 60, 58091, Hagen, Germany, Klinik-Ambrock.pneumo@t-online.de.
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