Study of a Novel APAP Algorithm for the Treatment of Obstructive Sleep Apnea in Women

McArdle, Nigel; King, Stuart; Shepherd, Kelly; Baker, Vanessa A.; Ramanan, Dinesh; Ketheeswaran, Sahisha; Bateman, P; Wimms, Alison; Armitstead, Jeff; Richards, Glenn; Hillman, David R.; Eastwood, Peter R.

doi:10.5665/sleep.5162

Cited by 31 publications

(15 citation statements)

References 27 publications

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“…A randomized, double-blind, crossover clinical trial found this modality to be as effective as standard continuous PAP. 82 Non-PAP treatments have rarely been studied in the female-specific population. Weight loss has been seen to be more beneficial for males than females based on the fat distribution in the upper airway of males.…”

Section: Treatmentmentioning

confidence: 99%

Obstructive Sleep Apnea in Women

Ayub

Won

2019

J Sleep Med

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Obstructive sleep apnea is known to be more prevalent in men. In women the prevalence varies throughout her life span as she goes through different stages; puberty, reproductive years, pregnancy and postmenopausal state. The disparity of prevalence within the lifespan of women and in comparison, to men is not only due to different pathophysiologic factors like upper airway anatomy, chemoreflexes, sex hormones but also due to under recognition of sleep disordered breathing in women due to atypical presentation and difference in polysomnographic phenotypes. This review summarizes the literature regarding sleep-disordered breathing in women, its pathophysiology, sex differences in phenotypes and implications of sex differences on management.

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Section: Treatmentmentioning

confidence: 99%

Obstructive Sleep Apnea in Women

Ayub

Won

2019

J Sleep Med

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“…However, in the female OSA patients, the longest apneas are associated with to a more severe oxygen desaturation [59]. Finally, the female OSA pattern characterized by a significant high percentage of hypopneas and respiratory effort-related arousal (RERA) events [60] has inspired the development of Auto CPAP, working by increasing sensitivity to flow limitation and optimizing the response to these events, with the control of OSA at a lower pressure [61,62].…”

Section: Further Psg/pm Patterns Useful For Clinical Managementmentioning

confidence: 99%

Phenotyping the pathophysiology of obstructive sleep apnea using polygraphy/polysomnography: a review of the literature

et al. 2018

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Continuous positive airway pressure (CPAP) is the first-line treatment for the majority of patients affected by obstructive sleep apnea syndrome (OSA). However, long-term compliance with CPAP therapy may result limited and alternatives to CPAP therapy are required to address the increasing need to provide tailored therapeutic options. Understanding the pathophysiological traits (PTs) of OSA patients [upper airway (UA) anatomical collapsibility, loop gain (LG), arousal threshold (AT), and UA gain (UAG)] lies at the heart of the customized OSA treatment. However, sleep research laboratories capable to phenotype OSA patients are sparse and the diagnostic procedures time-consuming, costly, and requiring significant expertise. The question arises whether the use of routine clinical polysomnography or nocturnal portable multi-channel monitoring (PSG/PM) can provide sufficient information to characterize the above traits. The aim of the present review is to deduce if the information obtainable from the clinical PSG/PM analysis, independently of the scope and context of the original studies, is clinically useful to define qualitatively the PTs of individual OSA patients. In summary, it is possible to identify four patterns using PSG/PM that are consistent with an altered UA collapsibility, three that are consistent with altered LG, two with altered AT, and three consistent with flow limitation/UA muscle response. Furthermore, some PSG/PM indexes and patterns, useful for the suitable management of OSA patient, have been discussed. The delivery of this clinical approach to phenotype pathophysiological traits will allow patients to benefit in a wider range of sleep services by facilitating tailored therapeutic options.

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“…One commercially available CPAP device contains an algorithm which aims to address female-specific OSA characteristics. This device was tested in a randomized, double-blind, crossover clinical trial and was found to be as effective as standard CPAP, with a significant reduction in residual flow limitation and lower mean pressures [ 92 ]. An ongoing clinical study is investigating the use of this device on quality of life in women, with outcome measures including daily functioning, sleepiness, depression, sexual function, and sleep quality ( NCT02400073 ).…”

Section: Osa Treatmentmentioning

confidence: 99%

Obstructive Sleep Apnea in Women: Specific Issues and Interventions

Wimms

Woehrle

Ketheeswaran

et al. 2016

BioMed Research International

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123

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Obstructive sleep apnea (OSA) has traditionally been seen as a male disease. However, the importance of OSA in women is increasingly being recognized, along with a number of significant gender-related differences in the symptoms, diagnosis, consequences, and treatment of OSA. Women tend to have less severe OSA than males, with a lower apnea-hypopnea index (AHI) and shorter apneas and hypopneas. Episodes of upper airway resistance that do not meet the criteria for apneas are more common in women. Prevalence rates are lower in women, and proportionally fewer women receive a correct diagnosis. Research has also documented sex differences in the upper airway, fat distribution, and respiratory stability in OSA. Hormones are implicated in some gender-related variations, with differences between men and women in the prevalence of OSA decreasing as age increases. The limited data available suggest that although the prevalence and severity of OSA may be lower in women than in men, the consequences of the disease are at least the same, if not worse for comparable degrees of severity. Few studies have investigated gender differences in the effects of OSA treatment. However, given the differences in physiology and presentation, it is possible that personalized therapy may provide more optimal care.

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Study of a Novel APAP Algorithm for the Treatment of Obstructive Sleep Apnea in Women

Cited by 31 publications

References 27 publications

Obstructive Sleep Apnea in Women

Obstructive Sleep Apnea in Women

Phenotyping the pathophysiology of obstructive sleep apnea using polygraphy/polysomnography: a review of the literature

Obstructive Sleep Apnea in Women: Specific Issues and Interventions

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