scholarly journals The new procedure for manual CPAP titration : the afternoon CPAP titration (aPT)

2021 ◽  
Vol 68 (1.2) ◽  
pp. 170-174
Author(s):  
Keisuke Kido ◽  
Naoko Tachibana
Keyword(s):  
Cpap Titration

CPAP titration: Different methods for similar clinical results

2007 ◽  
Vol 18 (3) ◽  
pp. 230-234 ◽  
Author(s):  
Jose Luis Lopez-Campos ◽  
Cayo Garcia Polo ◽  
Antonio Leon Jimenez ◽  
Enrique Gonzalez-Moya ◽  
Aurelio Arnedillo ◽  
...  
Keyword(s):  
Clinical Results ◽  
Cpap Titration

The fine art of CPAP titration—will it ever become obsolete?

2007 ◽  
Vol 11 (2) ◽  
pp. 65-67 ◽  
Author(s):  
János Juhász
Keyword(s):  
Fine Art ◽  
Cpap Titration

Predictive equations for CPAP titration in OSAS patients

2011 ◽  
Vol 16 (1) ◽  
pp. 95-100 ◽  
Author(s):  
Donato Lacedonia ◽  
Roberto Sabato ◽  
Giovanna E Carpagnano ◽  
Pierluigi Carratù ◽  
Antonio Falcone ◽  
...  
Keyword(s):  
Predictive Equations ◽  
Cpap Titration

Is automatic CPAP titration as effective as manual CPAP titration in OSAHS patients? A meta-analysis

2011 ◽  
Vol 16 (2) ◽  
pp. 329-340 ◽  
Author(s):  
Weijie Gao ◽  
Yinghui Jin ◽  
Yan Wang ◽  
Mei Sun ◽  
Baoyuan Chen ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Cpap Titration

843 Paradoxical Waking Hypoxemia that Improves with Sleep

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A328-A328
Author(s):  
Jessica Cho ◽  
David Dai ◽  
Constance Fung
Keyword(s):  
Pulmonary Hypertension ◽  
Case Reports ◽  
Supplemental Oxygen ◽  
Nocturnal Hypoxemia ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Paradoxical Worsening ◽  
Chronic Hypoxemia ◽  
Function Testing ◽  
Titration Study

Abstract Introduction We present a case of paradoxically worsened hypoxia during wake phase of polysomnography while undergoing a CPAP titration study. Nighttime hypoxemia is a common feature in obstructive sleep apnea, due to obstructive events that manifest while sleeping. Excluding OSA, there remains an extensive differential for disease processes that cause hypoxemia while asleep; however, none of these processes can explain waking hypoxemia that improves upon sleeping. Report of case(s) A 70 year old male with severe OSA diagnosed by home sleep test (REI 46.5, nadir O2=76%) underwent polysomnography with PAP titration and demonstrated several hours of interrupted sleep without hypoxia and minimal obstructive events on CPAP 9–13 cmH2O. During the study, while awake at CPAP of 14 cmH2O, he developed hypoxia to mid-high 80s and supplemental oxygen bleed in was added starting at 3L and increased to 5L during a prolonged period of wakefulness. On CPAP 15 cmmH2O with 5L bleed-in, the patient fell asleep and oxygen saturation again increased to low 90s. He underwent an extensive workup for other cardiopulmonary causes of hypoxemia, with pulmonary function testing showing moderate obstructive ventilatory defect and mild DLCO impairment. An echocardiogram with saline contrast bubble study was relatively unremarkable, without evidence of right to left shunting. He underwent a chest CTA which was negative for pulmonary embolism, though it did reveal an enlarged pulmonary artery consistent with pulmonary hypertension. His chronic hypoxemia was treated with 2L supplemental oxygen during the day and bleed-in with CPAP at night. Conclusion Though nocturnal hypoxemia is common with OSA, polysomnography with paradoxical hypoxemia during wake phase has not been reported. Notably, the patient was without prolonged hypoxia during his sleep phase while on CPAP treatment with minimal apneic/hypopneic events. Pulmonary hypertension can also present as nocturnal hypoxemia, but it should worsen with sleep, rather than improve. There are case reports of right to left shunting worsened by PAP, though his hypoxemia persisted despite PAP. His paradoxical worsening hypoxemia with wakefulness is still unexplained. Support (if any):

scholarly journals 0670 The Outcome Of Cpap Titration Under Drug-induced Sleep Endoscopy: A Randomized Controlled Crossover Trial

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A255-A256
Author(s):  
T Wang ◽  
T Lin ◽  
Y Ni ◽  
Y Lo
Keyword(s):  
Crossover Trial ◽  
Independent Factor ◽  
Sleep Endoscopy ◽  
Drug Induced ◽  
Randomized Controlled ◽  
Cpap Treatment ◽  
Drug Induced Sleep Endoscopy ◽  
Cpap Titration ◽  
Significant Difference ◽  
Anterior Posterior

Abstract Introduction The titration pressure of continuous positive airway pressure (CPAP) is an important issue for patients with obstructive sleep apnea (OSA). The aim of this study was to understand the impact of drug-induced sleep endoscopy (DISE)-guided CPAP pressure and doctor-guided CPAP pressure on patients with OSA. Methods In this randomized controlled single-blinded crossover trial, we compared the effects of 1 month CPAP treatment on patients with OSA. Twenty-four patients with OSA were recruited and completed this study. They all underwent polysomnography, DISE-guided CPAP titration and accommodation. Doctor-guided CPAP pressure was determined before DISE. Patients were randomly assigned to receive DISE-guided or Doctor-guided CPAP pressure treatment for 1 month. Then, they switched to another CPAP pressure for another 1 month. Epworth sleepiness scale (ESS) will be recorded at baseline, 1 month and 2 months. Results The DISE-guided CPAP pressure and Doctor-guided CPAP pressure had no significant difference (13.9±0.7 cm H2O vs 13.5±0.5 cm H2O; P=0.92). In addition, residual AHI and compliance were also no significant difference between two groups. The ESS was significantly improved from baseline to 1 month CPAP treatment in both groups. Epiglottis (anterior-posterior collapse) was significant associated with AHI (P < 0.001, by Spearman correlation). Both Epiglottis (anterior-posterior collapse) and tongue base collapse were significant associated with 95% CPAP pressure (P = 0.031 and 0.038). After multivariate regression analyses, epiglottis (anterior-posterior collapse) is the independent factor for 95% CPAP pressure. Conclusion The DISE-guided CPAP pressure and Doctor-guided CPAP pressure had no significant difference on the improvement of ESS. Epiglottis (anterior-posterior collapse) is the independent factor for AHI and 95% CPAP pressure. Support Chang Gung Memorial Hospital and Chang Gung University

scholarly journals An assessment of a simple clinical technique to estimate pharyngeal collapsibility in people with obstructive sleep apnea

SLEEP ◽  
2020 ◽  
Vol 43 (10) ◽  
Author(s):  
Amal M Osman ◽  
Benjamin K Tong ◽  
Shane A Landry ◽  
Bradley A Edwards ◽  
Simon A Joosten ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Characteristic Curve ◽  
Upper Airway ◽  
Clinical Intervention ◽  
Apnea Hypopnea Index ◽  
Cpap Titration ◽  
Obstructive Sleep ◽  
Airway Collapsibility ◽  
Upper Airway Collapsibility

Abstract Study Objectives Quantification of upper airway collapsibility in obstructive sleep apnea (OSA) could help inform targeted therapy decisions. However, current techniques are clinically impractical. The primary aim of this study was to assess if a simple, novel technique could be implemented as part of a continuous positive airway pressure (CPAP) titration study to assess pharyngeal collapsibility. Methods A total of 35 participants (15 female) with OSA (mean ± SD apnea–hypopnea index = 35 ± 19 events/h) were studied. Participants first completed a simple clinical intervention during a routine CPAP titration, where CPAP was transiently turned off from the therapeutic pressure for ≤5 breaths/efforts on ≥5 occasions during stable non-rapid eye movement (non-REM) sleep for quantitative assessment of airflow responses (%peak inspiratory flow [PIF] from preceding 5 breaths). Participants then underwent an overnight physiology study to determine the pharyngeal critical closing pressure (Pcrit) and repeat transient drops to zero CPAP to assess airflow response reproducibility. Results Mean PIF of breaths 3–5 during zero CPAP on the simple clinical intervention versus the physiology night were similar (34 ± 29% vs. 28 ± 30% on therapeutic CPAP, p = 0.2; range 0%–90% vs. 0%–95%). Pcrit was −1.0 ± 2.5 cmH2O (range −6 to 5 cmH2O). Mean PIF during zero CPAP on the simple clinical intervention and the physiology night correlated with Pcrit (r = −0.7 and −0.9, respectively, p < 0.0001). Receiver operating characteristic curve analysis indicated significant diagnostic utility for the simple intervention to predict Pcrit < −2 and < 0 cmH2O (AUC = 0.81 and 0.92), respectively. Conclusions A simple CPAP intervention can successfully discriminate between patients with and without mild to moderately collapsible pharyngeal airways. This scalable approach may help select individuals most likely to respond to non-CPAP therapies.

Impact of upper airway configuration on CPAP titration assessed by CT during Müller's maneuver in OSA patients

2021 ◽  
Vol 284 ◽  
pp. 103559
Author(s):  
Han-Sheng Xie ◽  
Gong-Ping Chen ◽  
Jie-feng Huang ◽  
Jian-Ming Zhao ◽  
Ai-Ming Zeng ◽  
...  
Keyword(s):  
Upper Airway ◽  
Cpap Titration ◽  
Muller’S Maneuver

scholarly journals Inferior Turbinate Size and CPAP Titration Based Treatment Pressures: No Association Found among Patients Who Have Not Had Nasal Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Macario Camacho ◽  
Soroush Zaghi ◽  
Daniel Tran ◽  
Sungjin A. Song ◽  
Edward T. Chang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Inferior Turbinate ◽  
Oxygen Desaturation ◽  
Apnea Hypopnea Index ◽  
Strongly Correlated ◽  
Nasal Surgery ◽  
Therapeutic Treatment ◽  
Oxygen Desaturation Index ◽  
Cpap Titration

Objective. To evaluate the effect of turbinate sizes on the titrated continuous positive airway pressure (CPAP) therapeutic treatment pressures for patients with obstructive sleep apnea (OSA) who have not had nasal surgery.Study Design. Retrospective case series.Methods. A chart review was performed for 250 consecutive patients.Results. 45 patients met inclusion criteria. The mean ± standard deviation (M ± SD) for age was54.6±22.4years and for body mass index was28.5±5.9 kg/m2. The Spearman’s rank correlation coefficient (rs) between CPAP therapeutic treatment pressures and several variables were calculated and were weakly correlated (agers=0.29, nasal obstructionrs=-0.30), moderately correlated (body mass indexrs=0.42and lowest oxygen saturationrs=-0.47), or strongly correlated (apnea-hypopnea indexrs=0.60and oxygen desaturation index (rs=0.62)). No statistical significance was found with one-way analysis of variance (ANOVA) between CPAP therapeutic treatment pressures and inferior turbinate size (right turbinatespvalue = 0.2012, left turbinatepvalue = 0.3064), nasal septal deviation (pvalue = 0.4979), or mask type (pvalue = 0.5136).Conclusion. In this study, CPAP titration based therapeutic treatment pressures were not found to be associated with inferior turbinate sizes; however, the CPAP therapeutic treatment pressures were strongly correlated with apnea-hypopnea index and oxygen desaturation index.

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