Évaluation de l’observance et de l’acceptation du traitement du syndrome d’apnées obstructives du sommeil par pression positive continue. Étude prospective de 72 patients appareillés entre 2004 et 2007

Ahmed, Ashir; Slama, Sana Ben; Hayouni, A.; Harrabi, Imed; Mezghanni, S.; Garrouche, A.; Klabi, N.; Benzarti, M.; Jerray, M.

doi:10.1016/j.pneumo.2009.03.010

Cited by 9 publications

(4 citation statements)

References 19 publications

(20 reference statements)

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“…Other reasons that may have affected the acceptance rate are that the retrospective study design is closer to the real-world setting and that the strong national health insurance and healthcare in Taiwan is so convenient and inexpensive that the Taiwanese pay little attention on health maintenance. Overall CPAP compliance of our patients was 71.4% (120 out of 168 patients) and is comparable with that found in studies in Europe and US which were about 75% and 46%, respectively [ 42 , 43 , 46 – 49 ]. Reasons for the wide range of compliance across countries include different definition of compliance and different sources of CPAP.…”

Section: Discussionsupporting

confidence: 90%

“…Acceptance rates from other studies range from 40-90% [ 38 – 45 ]. In the studies in which the acceptance rate is higher (about 70%), often CPAP is free to subject participating in these trials [ 42 – 45 ]. Other reasons that may have affected the acceptance rate are that the retrospective study design is closer to the real-world setting and that the strong national health insurance and healthcare in Taiwan is so convenient and inexpensive that the Taiwanese pay little attention on health maintenance.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of cardiovascular co-morbidities and CPAP use in patients with positional and non-positional mild obstructive sleep apnea

et al. 2014

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BackgroundThis retrospective cohort study aimed to determine if there are differences in cardiovascular co-morbidities, blood pressure (BP) and continuous positive airway pressure (CPAP) use between patients with positional-dependent and nonpositional-dependent obstructive sleep apnea (OSA).MethodsPatients who were referred for overnight polysomnography for suspected OSA between 2007 and 2011 were screened. A total of 371 patients with OSA were included for analysis and divided into six groups according to positional-dependency and severity of OSA: positional mild (n = 52), positional moderate (n = 29), positional severe (n = 24), non-positional mild (n = 18), non-positional moderate (n = 70) and non-positional severe group (n = 178). The six groups were compared for anthropometric and polysomnographic variables, presence of cardiovascular co-morbidities, morning and evening BP and the changes between evening and morning BP, and CPAP device usage patterns.ResultsDemographic and anthropometric variables showed non-positional severe OSA had poor sleep quality and higher morning blood pressures. Positional mild OSA had the lowest cardiovascular co-morbidities. Overall CPAP acceptance was 45.6%. Mild OSA patients had the lowest CPAP acceptance rate (10%), followed by moderate group (37.37%) and severe group (61.88%, P < 0.001). However, the significant difference in CPAP acceptance across OSA severity disappeared when the data was stratified by positional dependency.ConclusionsThis study found that positional mild OSA had less cardiovascular co-morbidities compared with subjects with positional severe OSA. Independent of posture, CPAP acceptance in patients with mild OSA was low, but CPAP compliance was similar in CPAP acceptors regardless of posture dependency of OSA. Since there are increasing evidences of greater cardiovascular risk for untreated mild OSA, improving CPAP acceptance among mild OSA patients may be clinically important regardless of posture dependency.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Comparison of cardiovascular co-morbidities and CPAP use in patients with positional and non-positional mild obstructive sleep apnea

et al. 2014

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“…Approximately 40% of patients are no longer complaint with the treatment after 3 years [70]. However, it seems that patients with the most severe sleep apnea are more likely to be complaint.…”

Section: Clinical Implications Of Appropriate Treatment In Osa Patmentioning

confidence: 99%

Atrial Arrhythmias in Obstructive Sleep Apnea: Underlying Mechanisms and Implications in the Clinical Setting

et al. 2013

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Obstructive sleep apnea (OSA) is a common disorder characterized by repetitive interruption of ventilation during sleep caused by recurrent upper airway collapse, which leads to intermittent hypoxia. The disorder is commonly undiagnosed despite its relationship with substantial cardiovascular morbidity and mortality. Moreover, the effects of the disorder appear to be particularly dangerous in young subjects. In the last decade, substantial clinical evidence has identified OSA as independent risk factor for both bradyarrhythmias and tachyarrhythmias. To date the mechanisms leading to such arrhythmias have not been completely understood. However, recent data from animal models and new molecular analyses have increased our knowledge of the field, which might lead to future improvement in current therapeutic strategies mainly based on continuous positive airway pressure. This paper aims at providing readers a brief and specific revision of current knowledge about the mechanisms underlying atrial arrhythmias in OSA and their clinical and therapeutic implications.

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“…Its prevalence is about 2 to 4 % in adults [1]. Continuous positive airway pressure (CPAP) is the preferred method for treating OSAHS; however, 40 % patients with OSAHS cannot tolerate or are unwilling to accept CPAP treatment [2]. They instead choose to undergo other treatments, such as surgery.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and mechanism of mandibular advancement devices for persistent sleep apnea after surgery: a prospective study

Luo

Tang

Xiong

et al. 2016

J of Otolaryngol - Head & Neck Surg

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BackgroundTo explore the feasibility, the efficacy, and the mechanism of mandibular advancement devices (MAD) in the treatment of persistent sleep apnea after surgery.MethodsNineteen patients who failed uvulopalatopharyngoplasty (UPPP) or UPPP plus genioglossus advancement and hyoid myotomy (GAHM) were given a non-adjustable MAD for treatment. All patients had polysomnography (PSG) at least 6 months post-UPPP with and without the MAD. Seventeen patients had computed tomography (CT) examinations.ResultsAfter the application of MAD, the apnea hypopnea index (AHI) decreased significantly from 41.2 ± 13.1/h to 10.1 ± 5.6/h in the responder group. The response rate was 57.9 % (11/19). During sleep apnea/hypopnea acquired from sedated sleep, the cross-sectional area and anterior-posterior and lateral diameters of the velopharynx enlarged significantly from 4.2 ± 6.0 mm2 to 17.5 ± 15.3 mm2, 1.9 ± 2.3 mm to 6.5 ± 4.1 mm, and 1.1 ± 1.3 mm to 2.6 ± 2.1 mm, respectively (P < 0.01) in the responder group with MAD. The velopharyngeal collapsibility also decreased significantly from 83.3 ± 21.8 % to 46.5 ± 27.1 %. The glossopharyngeal collapsibility decreased from 39.8 ± 39.1 % to −22.9 ± 73.2 % (P < 0.05).ConclusionMAD can be an effective alternative treatment for patients with moderate and severe OSAHS after surgery. The principal mechanisms underlying the effect of MAD are expansion of the lateral diameter of the velopharynx, the enlargement of the velopharyngeal area, the reduction of velopharyngeal and glossopharyngeal collapsibility, and the stabilization of the upper airway.

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Évaluation de l’observance et de l’acceptation du traitement du syndrome d’apnées obstructives du sommeil par pression positive continue. Étude prospective de 72 patients appareillés entre 2004 et 2007

Cited by 9 publications

References 19 publications

Comparison of cardiovascular co-morbidities and CPAP use in patients with positional and non-positional mild obstructive sleep apnea

Comparison of cardiovascular co-morbidities and CPAP use in patients with positional and non-positional mild obstructive sleep apnea

Atrial Arrhythmias in Obstructive Sleep Apnea: Underlying Mechanisms and Implications in the Clinical Setting

Efficacy and mechanism of mandibular advancement devices for persistent sleep apnea after surgery: a prospective study

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