Complex sleep apnoea syndrome

Verbraecken, Johan

doi:10.1183/20734735.042412

Cited by 14 publications

(16 citation statements)

References 48 publications

(82 reference statements)

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“… 1 , 4 , 5 , 6 , 7 , 8 , 9 Reported prevalence rates range from 0.56% to 20.3%. 1 , 4 , 5 , 6 , 7 , 8 , 9 , 10 This large variation can be attributed to many methodologic and biologic factors, including patient demographic and clinical characteristics such as body mass index, sex, age, and comorbidities, and procedure-related factors like split-night titration and titration in the supine position. 4 , 8 , 10 , 11 In addition, sample sizes in existing studies have been generally small.…”

mentioning

confidence: 99%

Trajectories of Emergent Central Sleep Apnea During CPAP Therapy

Liu¹,

Armitstead

Benjafield

et al. 2017

Chest

103

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BackgroundThe emergence of central sleep apnea (CSA) during positive airway pressure (PAP) therapy has been observed clinically in approximately 10% of obstructive sleep apnea titration studies. This study assessed a PAP database to investigate trajectories of treatment-emergent CSA during continuous PAP (CPAP) therapy.MethodsU.S. telemonitoring device data were analyzed for the presence/absence of emergent CSA at baseline (week 1) and week 13. Defined groups were as follows: obstructive sleep apnea (average central apnea index [CAI] < 5/h in week 1, < 5/h in week 13); transient CSA (CAI ≥ 5/h in week 1, < 5/h in week 13); persistent CSA (CAI ≥ 5/h in week 1, ≥ 5/h in week 13); emergent CSA (CAI < 5/h in week 1, ≥ 5/h in week 13).ResultsPatients (133,006) used CPAP for ≥ 90 days and had ≥ 1 day with use of ≥ 1 h in week 1 and week 13. The proportion of patients with CSA in week 1 or week 13 was 3.5%; of these, CSA was transient, persistent, or emergent in 55.1%, 25.2%, and 19.7%, respectively. Patients with vs without treatment-emergent CSA were older, had higher residual apnea-hypopnea index and CAI at week 13, and more leaks (all P < .001). Patients with any treatment-emergent CSA were at higher risk of therapy termination vs those who did not develop CSA (all P < .001).ConclusionsOur study identified a variety of CSA trajectories during CPAP therapy, identifying several different clinical phenotypes. Identification of treatment-emergent CSA by telemonitoring could facilitate early intervention to reduce the risk of therapy discontinuation and shift to more efficient ventilator modalities.

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confidence: 99%

Trajectories of Emergent Central Sleep Apnea During CPAP Therapy

Liu¹,

Armitstead

Benjafield

et al. 2017

Chest

103

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“…However, CPAP seems to be effective in some patients, while ineffective in others; CompSAS may develop de novo in 4% of OSAS patients treated with CPAP during follow up (17). Very few data are available on CPAP compliance, but there are suggestions that CompSAS patients may have a lower effect of CPAP on sleep as well as on breathing parameters, more dyspnea, poorer CPAP adherence and more often report spontaneous removal of the mask at night (18).…”

Section: Editorialmentioning

confidence: 99%

Central sleep apnea during continuous positive airway pressure therapy in obstructive sleep apnea patients: from the compliance to adaptation, maladaptation and reflexes

Lombardi¹,

Caravita²,

Parati³

2017

J. Thorac. Dis.

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“…Probably the cause of the syndrome is the application of high CPAP pressure in obstructive sleep apnea patients with enhanced chemoreceptor sensitivity or in patients with sleep fragmentation. 6 Treatment modalities consist in the avoidance of high pressure and permissive flow limitation, and advanced ventilation techniques: bilevel-positive airway pressure ventilation in the spontaneous-timed mode or adaptive servo-ventilation (ASV). 6…”

Section: Complex Sleep Apneamentioning

confidence: 99%

Sleep-related breathing disorders and non-invasive ventilation

Lax

Banfi

et al. 2015

Ital J Med

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Non-invasive mechanical ventilation (NPPV) was originally used in patients with acute respiratory impairment or exacerbations of chronic respiratory diseases, as an alternative to the endotracheal tube. Over the last thirty years NPPV has been also used at night in patients with stable chronic lung disease such as obstructive sleep apnea, the overlap syndrome (chronic obstructive pulmonary disease and obstructive sleep apnea), neuromuscular disorders, obesity-hypoventilation syndrome, and in other conditions such as sleep disorders associated with congestive heart failure (Cheyne-Stokes respiration). In this no-systematic review we discuss the different types of NPPV, the specific conditions in which they can be used and the indications, recommendations and evidence supporting the efficacy of NPPV. Optimizing patient acceptance and adherence to non-invasive ventilation treatment is challenging. The treatment of sleep-related disorders is a life-threatening condition. The optimal level of treatment should be determined in a sleep laboratory. Side effects directly affecting the patient's adherence to treatment are known. The most common are nasopharyngeal symptoms including increased congestion and rhinorrhea; these effects are related to reduced humidity of inspired gas. Humidification of delivered gas may improve these symptoms.

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Complex sleep apnoea syndrome

Cited by 14 publications

References 48 publications

Trajectories of Emergent Central Sleep Apnea During CPAP Therapy

Trajectories of Emergent Central Sleep Apnea During CPAP Therapy

Central sleep apnea during continuous positive airway pressure therapy in obstructive sleep apnea patients: from the compliance to adaptation, maladaptation and reflexes

Sleep-related breathing disorders and non-invasive ventilation

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