Positive airway pressure level based upper airway collapsibility classification – the European Sleep Apnea Database (ESADA)
Bildiriler > Özet Bildiri
Yazarlar: Ding Zou, Sophia Schiza, Tarja Saaresranta, Athanasia Pataka, Johan Verbraecken, Carolina Lombardi, Holger Hein, Pavol Joppa, Ondrej Ludka, Maria R. Bonsignore, Silke Ryan, Özen KAÇMAZ BAŞOĞLU
Sleep and control of breathing, , , Uluslararası, Özet Bildiri, ss PA2492-PA2492
DOI: 10.1183/13993003.congress-2021.pa2492
Özet
Background and objectives: Obstructive sleep apnea (OSA) patients with mild upper airway collapsibility represents a target group for potential non-positive airway pressure (PAP) treatment. We studied the clinical characteristics of this endotypic group in a large Pan-European sleep apnea registry. Methods: A retrospective analysis was performed in 2541 OSA patients with fixed PAP treatment (male 74%, age 53±11 years, body mass index [BMI] 33±6 kg/m2, apnea-hypopnea index [AHI] 41±25 events/h at baseline). Therapeutic PAP level ≤8 cm H2O was used as the cut-off to classify patients with mild upper airway collapsibility (Landry SA et al. Sleep 2017; 40:6). Results: Mean pressure of the PAP therapy was 9±2 cm H2O and treatment compliance was 5.1±2.1 h/day. A total of 39% of patients had a PAP level ≤8 cm H2O. In a multivariate logistic regression model, compared to patients with PAP >8 cm H2O, hyperlipidemia was more prevalent in mild airway collapsibility patients (OR [95%CI] 1.23 [1.00-1.51], p=0.047). BMI, waist-to-hip ratio, neck circumference, AHI and diagnosis of hypertension were negatively associated with the mild collapsibility group (0.97 [0.95-0.99], 0.26 [0.10-0.64], 0.96 [0.93-1.00], 0.99 [0.98-0.99], 0.75 [0.61-0.92], p=0.006, 0.003, 0.034, <0.001, and 0.007, respectively). PAP compliance did not differ between the mild and more severe airway collapsibility groups (p=0.89). Conclusion: Body composition, comorbidities and OSA severity predicted mild upper airway collapsibility defined by therapeutic PAP level in the ESADA cohort. PAP-based phenotyping approach may provide a simple tool for personalized medicine in OSA.