Comparison of American Academy of Sleep Medicine (AASM) versus Center for Medicare and Medicaid Services (CMS) polysomnography (PSG) scoring rules on AHI and eligibility for continuous positive airway pressure (CPAP) treatment

2016 ◽  
Vol 20 (4) ◽  
pp. 1169-1174 ◽  
Author(s):  
Arkady Korotinsky ◽  
Samson Z Assefa ◽  
Montserrat Diaz-Abad ◽  
Emerson M Wickwire ◽  
Steven M Scharf
Keyword(s):  
Continuous Positive Airway Pressure ◽  
American Academy ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Medicine ◽  
Scoring Rules ◽  
Cpap Treatment ◽  
Versus Center

scholarly journals 0053 Effect of Changes in Intracellular Adhesion Molecule-1 on Measures of Sleepiness and 24-hour Ambulatory Blood Pressure After 4 Months of Continuous Positive Airway Pressure

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A21-A21
Author(s):  
V M Pak ◽  
D Maislin ◽  
B T Keenan ◽  
R Townsend ◽  
S B Dunbar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Adhesion Molecule ◽  
Ambulatory Blood Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Cpap Treatment ◽  
Arterial Blood ◽  
Obstructive Sleep

Abstract Introduction Previous studies have shown that continuous positive airway pressure (CPAP) therapy of adults with obstructive sleep apnea (OSA) reduces circulating levels of intercellular adhesion molecule 1 (ICAM-1). ICAM-1 levels may affect daytime sleepiness and elevated blood pressure associated with OSA. Our goals were to explore associations between changes in ICAM-1 and objective and subjective measures of sleepiness, as well as 24-hour ambulatory blood pressure monitor (ABPM) parameters in adults with OSA following 4 months of CPAP treatment. Methods We identified 140 adults with newly diagnosed OSA in the Penn Icelandic Sleep Apnea (PISA) Study, with a mean (±SD) body mass index (BMI) of 31.5±4.2 kg/m2 and apnea-hypopnea index (AHI) of 36.8±15.3 events/hour; 83.3% were males. Plasma ICAM-1 levels, 24-hour ABPM, Epworth Sleepiness Scale (ESS), and Psychomotor Vigilance Task (PVT) measures were obtained at baseline and after 4 months of CPAP treatment. Associations between changes in natural log ICAM-1 and both sleepiness and 24-hour mean arterial blood pressure (MAP) were assessed using multivariate regression models, controlling for a priori baseline covariates of age, sex, BMI, race, site, smoking status, physical activity, use of anti-hypertensive medications, AHI and hours/night of CPAP usage. Results Overall, there was no significant change in ICAM-1 from baseline to follow-up among all participants after 4 months (0.027 ng/ml, p=0.52). There were no statistically significant associations between the change in ICAM-1 and change in sleepiness measures (all p>0.05) or 24-hour MAP (1.124 mm Hg, p=0.07). A nominal association between increased ICAM-1 and increased daytime MAP after 4 months was observed (1.39 mm Hg, p=0.033), although this result was not significant after correction for multiple comparisons. Conclusion Our results do not support changes in ICAM-1 as the biological pathway linking changes in sleepiness or ABPM following CPAP treatment of adults with OSA. Support P01-HL094307 (NHLBI, PI: Pack AI)

scholarly journals Continuous positive airway pressure treatment for obstructive sleep apnoea: Maori, Pacific and New Zealand European experiences

2014 ◽  
Vol 6 (3) ◽  
pp. 221 ◽  
Author(s):  
Jessie Bakker ◽  
Karyn O’Keeffe ◽  
Alister Neill ◽  
Angela Campbell
Keyword(s):  
New Zealand ◽  
Continuous Positive Airway Pressure ◽  
Obstructive Sleep Apnoea ◽  
Role Models ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnoea ◽  
Cpap Adherence ◽  
Cpap Treatment ◽  
Obstructive Sleep

INTRODUCTION: Continuous positive airway pressure (CPAP) is an effective treatment of obstructive sleep apnoea (OSA), but can be limited by poor adherence. In New Zealand (NZ), ethnicity has been shown to be a predictor of CPAP adherence. This study aimed to explore Maori, Pacific and NZ European patients’ experience of CPAP treatment. METHODS: Patients identifying as Maori, Pacific, or NZ European ethnicity referred for CPAP treatment for OSA attended separate, 1.5-hour group discussions facilitated by a health care worker of the same ethnic group, using an interview template. Thematic analysis was applied to the discussion transcripts independently by two investigators, following published guidelines. FINDINGS: Five Maori, five Pacific, and eight NZ Europeans participated (mean age 47, range 30–71 years, mean ± standard deviation CPAP adherence 6.32 ±1.25 hours/night). Patients in all three groups reported that they had little knowledge of OSA or CPAP prior to treatment initiation. All groups identified barriers to treatment (both at the CPAP initiation phase and long term), reported feelings of being ‘overwhelmed’ with information during the initial CPAP education session, and discussed the importance of successful role models. Family and friends were generally reported as being supportive of CPAP therapy. CONCLUSION: The three groups all reported similar initial CPAP experiences, highlighting access barriers to publicly funded assessment and treatment pathways, and sleep health knowledge as key issues. Educational resources to improve access, enable self-management, and increase community awareness of OSA would help overcome some of the issues identified in this study. KEYWORDS: Continuous positive airway pressure; obstructive sleep apnea; ethnic groups; focus groups

Measurement of Ventilation and Respiratory Mechanics during Continuous Positive Airway Pressure (CPAP) Treatment in Infants

1989 ◽  
Vol 78 (2) ◽  
pp. 194-204 ◽  
Author(s):  
BENGT ANDRÉASSON ◽  
MAGNUS LINDROTH ◽  
NILS W. SVENNINGSEN ◽  
BJÖRN DREFELDT ◽  
GERT-INGE JÖNSSON ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Respiratory Mechanics ◽  
Positive Airway Pressure ◽  
Cpap Treatment

scholarly journals Do Obstructive Sleep Apnea Syndrome Patients Underestimate Their Daytime Symptoms before Continuous Positive Airway Pressure Treatment?

2014 ◽  
Vol 21 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Gabrielle Leclerc ◽  
Yves Lacasse ◽  
Diane Page ◽  
Frédéric Sériès
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Cpap Treatment ◽  
Obstructive Sleep ◽  
Before And After ◽  
Pretreatment Score

BACKGROUND: Daytime somnolence is an important feature of the obstructive sleep apnea (OSA) hypopnea syndrome and is usually subjectively assessed using the Epworth Sleepiness Scale (ESS).OBJECTIVE: To compare the scores of the ESS and different domains of the Quebec Sleep Questionnaire (QSQ) assessed before and after the first months of continuous positive airway pressure (CPAP) treatment, as well as retrospectively without treatment.METHODS: The ESS score and domain scores of the QSQ were obtained before and after a three-month period of CPAP treatment using a retrospective assessment of the pretreatment scores in 76 untreated OSA patients.RESULTS: Fifty-two patients completed the study. The ESS and QSQ scores significantly improved following CPAP therapy. Retrospective evaluation of the ESS score was significantly worse than pre- and post-treatment values (mean [± SD] pretreatment score 11.0±4.8; retrospective pretreatment score 13.5±5.1). Such differences were not observed in any domain of the QSQ, including the domain assessing hypersomnolence.CONCLUSION: OSA patients underestimated their sleepiness according to the most widely used instrument to assess hypersomnolence. This finding may not be observed with other methods used to assess OSA-related symptoms such as quality of life questionnaires.

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