Upper airway collapsibility in patients with OSA treated with continuous positive airway pressure: a retrospective preliminary study

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Marcello Bosi, Umberto I Hospital
  • ,
  • Serena Incerti Parenti, University of Bologna
  • ,
  • Andrea Fiordelli, University of Bologna
  • ,
  • Venerino Poletti, Morgagni-Pierantoni Hospital
  • ,
  • Giulio Alessandri-Bonetti, University of Bologna

STUDY OBJECTIVES: To investigate the prevalence of mildly collapsible upper airways (defined by therapeutic continuous positive airway pressure [CPAP] values ≤ 8 cm H₂O) in moderate to severe obstructive sleep apnea patients treated with CPAP and to determine their clinical, functional, and nocturnal polysomnographic characteristics. METHODS: Eighty-seven patients with moderate to severe obstructive sleep apnea consecutively treated with CPAP were retrospectively investigated. Two nocturnal home sleep portable monitoring studies were performed at baseline and during treatment. Participants were categorized according to therapeutic CPAP values: ≤ 8 cm H₂O (group 1), 8-12 cm H₂O (group 2), ≥ 12 cm H₂O (group 3). Anthropometric, awake respiratory function, symptoms, comorbidities, and nocturnal home sleep portable monitoring studies data were collected. RESULTS: Mild upper airway collapsibility (therapeutic CPAP values ≤ 8 cm H₂O) was present in 25.3% of patients. They showed more favorable apnea-hypopnea index, oxygen desaturation index, mean nocturnal saturation, sleep time with oxygen saturation < 90%, desaturation nadir, and supine position. Oxygen desaturation index showed a weak association with anatomical collapsibility. Using the receiver operating characteristic curve, the area under the curve for the oxygen desaturation index vs CPAP pressure requirements ≤ 8 cm H₂O was low and oxygen desaturation index ≤ 40.8/h showed a sensitivity of 63.3% and a specificity of 69.2% to detect patients with mild collapsibility. CONCLUSIONS: A quarter of moderate to severe patients under CPAP therapy had mild collapsibility and were likely to also be good candidates for alternative and better tolerated non-CPAP therapies. Baseline anthropometric, clinical, and respiratory function characteristics did not predict mild upper airway collapsibility determined by CPAP pressure requirements ≤ 8 cm H₂O.

Original languageEnglish
JournalJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Volume16
Issue11
Pages (from-to)1839-1846
Number of pages8
ISSN1550-9389
DOIs
Publication statusPublished - Nov 2020

    Research areas

  • continuous positive airway pressure, obstructive sleep apnea, upper airway collapsibility

See relations at Aarhus University Citationformats

ID: 201619546