J Appl Biomed 17:81, 2019 | DOI: 10.32725/jab.2018.008

Improved prediction of CPAP failure using T90, age and gender

David Slouka1,*, Monika Honnerova2, Petr Hosek3, Bretislav Gal4, Ondrej Trcka1, Tomas Kostlivy1, Jana Landsmanova5, David Havel2, Martina Baneckova6, Radek Kucera7
1 Charles University, Faculty of Medicine in Pilsen, Ear, Nose and Throat Department, Pilsen, Czech Republic
2 Charles University, Faculty of Medicine in Pilsen, Department of Pneumology, Pilsen, Czech Republic
3 Charles University, Faculty of Medicine in Pilsen, Biomedical Center, Pilsen, Czech Republic
4 Masaryk University, Faculty of Medicine, Ear, Nose and Throat Department, Brno, Czech Republic
5 Charles University, Faculty of Medicine in Pilsen, Department of Obstetrics and Gynaecology, Pilsen, Czech Republic
6 Charles University, Faculty of Medicine in Pilsen, Department of Pathology, Pilsen, Czech Republic
7 Charles University, Faculty of Medicine in Pilsen, Department of Nuclear Medicine Laboratory of Immunoanalysis, Pilsen, Czech Republic

Sleep apnea syndrome is associated with increased risk of cardiovascular disease. In treating older patients, there is a special emphasis put on minimally invasive and conservative procedures and a simple method for predicting the potential for treatment success is essential. Continuous positive airway pressure (CPAP) is the first choice for treatment, however, it is not always successful. In cases where CPAP was unsuccessful, treatment with bilevel positive airway pressure (BiPAP) is the next treatment option. In this study, we examine commonly evaluated respiratory parameters, obesity, and age relative to their ability to predict CPAP failure. We also tried to find differences in the predictive ability of these parameters in older and younger patients. The predictive ability, relative to CPAP failure, was examined for each individual parameter as well as for combinations of parameters. All variables had a statistical association with CPAP failure; failure prediction reliability ranged from poor to moderate. Combining T90, age, and gender can be used to find patients who will benefit from BiPAP as the first choice for treatment. An initial BiPAP indication can produce relevant reductions in treatment cost.

Keywords: Age; CPAP failure; Obesity; Prediction of failure; Sleep apnea syndrome
Grants and funding:

This project was supported by the grant of Ministry of Health of the Czech Republic – Conceptual Development of Research Organization (Faculty Hospital in Pilsen – FNPl, 00669806), and by the National Sustainability Program I (NPU I) No. LO1503 provided by the Ministry of Education Youth and Sports of the Czech Republic.

Conflicts of interest:

The authors have no conflict of interests to declare.

Received: November 6, 2018; Accepted: December 20, 2018; Prepublished online: January 10, 2019; Published: March 19, 2019  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Slouka D, Honnerova M, Hosek P, Gal B, Trcka O, Kostlivy T, et al.. Improved prediction of CPAP failure using T90, age and gender. J Appl Biomed. 2019;17(1):81. doi: 10.32725/jab.2018.008. PubMed PMID: 34907750.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Agresti A, Coull BA (1998). Approximate is better than "exact" for interval estimation of binomial proportions. Am Statistician 52(2): 119-126. DOI: 10.2307/2685469. Go to original source...
    2. Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Martínez-Alonso M, Carmona C, Barceló A, et al. (2012). Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA 307(20): 2161-2168. DOI: 10.1001/jama.2012.4366. Go to original source... Go to PubMed...
    3. Browaldh N, Markström A, Friberg D (2009). Elective tracheostomy is an alternative treatment in patients with severe obstructive sleep apnoea syndrome and CPAP failure. Acta Otolaryngol 129(10): 1121-1126. DOI: 10.1080/00016480802572509. Go to original source... Go to PubMed...
    4. Bruin PF, Bagnato M (2010). Cognitive impairment in obstructive sleep apnea syndrome. J Bras Pneumol 36 (Suppl. 2): 32-37. DOI: 10.1590/S1806-37132010001400010. Go to original source... Go to PubMed...
    5. Butner KL, Hargnes TA, Kaleth AS (2013). Association of obstructive sleep apnea severity with exercise capacity and health-related quality of life. N Am J Med Sci 5(6): 362-366. DOI: 10.4103/1947-2714.114168. Go to original source... Go to PubMed...
    6. Chowdhury O, Wedderburn CJ, Duffy D, Greenough A (2012). CPAP review. Eur J Pediatr 171(10): 1441-1448. DOI: 10.1007/s00431-011-1648-6. Go to original source... Go to PubMed...
    7. Dohi T, Kasai T, Narui K, Ishiwata S, Ohno M, Yamaguchi T, Momomura S (2008). Bi-level positive airway pressure ventilation for treating heart failure with central sleep apnea that is unresponsive to continuous positive airway pressure. Circ J 72(7): 1100-1105. DOI: 10.1253/circj.72.1100. Go to original source... Go to PubMed...
    8. Dostálová S, Susta M, Vorlová T, ©onka K (2012). Sleepiness in patients with obstructive sleep apnoea - daytime course and impact of nocturnal respiratory events. Neuro Endocrinol Lett 33(7): 684-688. Go to PubMed...
    9. Ephros HD, Madani M, Yalamanchili SC (2010). Surgical treatment of snoring & obstructive sleep apnoea. Indian J Med Res 131: 267-276.
    10. Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al. (2009). Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5(3): 263-276. Go to original source...
    11. Jalbert F, Lacassagne L, Bessard J, Dekeister C, Paoli JR, Tiberge M (2012). Oral appliances or maxillomandibular advancement osteotomy for severe obstructive sleep apnoea in patients refusing CPAP. Rev Stomatol Chir Maxillofac 113(1): 19-26. DOI: 10.1016/j.stomax.2011.11.005. Go to original source... Go to PubMed...
    12. Kasai T (2012). Sleep apnea and heart failure. J Cardiol 60(2): 78-85. DOI: 10.1016/j.jjcc.2012.05.013. Go to original source... Go to PubMed...
    13. La Piana GE, Scartabellati A, Chiesa L, Ronchi L, Raimondi P, Carro M, et al. (2011). Long-term adherence to CPAP treatment in patients with obstructive sleep apnea: importance of educational program. Patient Prefer Adherence 5: 555-562. DOI: 10.2147/PPA.S24018. Go to original source... Go to PubMed...
    14. Leidag M, Hader C, Keller T, Meyer Y, Rasche K (2008). Mask leakage in continuous positive airway pressure and C-Flex. J Physiol Pharmacol 59 (Suppl. 6): 401-406. Go to PubMed...
    15. Mannarino MR, Di Filippo F, Pirro M (2012). Obstructive sleep apnea syndrome. Eur J Intern Med 23(7): 586-593. DOI: 10.1016/j.ejim.2012.05.013. Go to original source... Go to PubMed...
    16. Maurer JT (2010). Surgical treatment of obstructive sleep apnea: standard and emerging techniques. Curr Opin Pulm Med 16(6): 552-558. DOI: 10.1097/MCP.0b013e32833ef7ea. Go to original source... Go to PubMed...
    17. Monahan K, Redline S (2011). Role of obstructive sleep apnea in cardiovascular disease. Curr Opin Cardiol 26(6): 541-547. DOI: 10.1097/HCO.0b013e32834b806a. Go to original source... Go to PubMed...
    18. Morales CR, Hurley S, Wick LC, Staley B, Pack FM, Gooneratne NS (2012). In-home, self-assembled sleep studies are useful in diagnosing sleep apnea in the elderly. Sleep 35(11): 1491-1501. DOI: 10.5665/sleep.2196. Go to original source... Go to PubMed...
    19. Mulgrew AT, Lawati NA, Ayas NT, Fox N, Hamilton P, Cortes L, Ryan CF (2010). Residual sleep apnea on polysomnography after 3 months of CPAP therapy: clinical implications, predictors and patterns. Sleep Med 11(2): 119-125. DOI: 10.1016/j.sleep.2009.05.017. Go to original source... Go to PubMed...
    20. Onen F, Onen H (2010). Obstructive sleep apnea and cognitive impairment in the elderly. Psychol Neuropsychiatr Vieil 8(3): 163-169. DOI: 10.1684/pnv.2010.0219. Go to original source... Go to PubMed...
    21. Piper AJ, Wang D, Yee BJ, Barnes DJ, Grunstein RR (2008). Randomised trial of CPAP vs bilevel support in the treatment of obesity hypoventilation syndrome without severe nocturnal desaturation. Thorax 63(5): 395-401. DOI: 10.1136/thx.2007.081315. Go to original source... Go to PubMed...
    22. Schäfer H, Ewig S, Hasper E, Lüderitz B (1998). Failure of CPAP therapy in obstructive sleep apnoea syndrome: predictive factors and treatment with bilevel-positive airway pressure. Respir Med 92(2): 208-215. DOI: 10.1016/S0954-6111(98)90097-X. Go to original source... Go to PubMed...
    23. ©edová L, Doskočil O, Brabcová I, Hajduchová H, Bártlová S (2016). Selected aspects of health literacy among seniors. Neuro Endocrinol Lett 37(Suppl. 2): 11-17. Go to PubMed...
    24. Sopkova Z, Dorkova Z, Tkacova R (2009). Predictors of compliance with continuous positive airway pressure treatment in patients with obstructive sleep apnea and metabolic syndrome. Wien Klin Wochenschr 121(11-12): 398-404. DOI: 10.1007/s00508-009-1181-z. Go to original source... Go to PubMed...
    25. Tóthová V, Bártlová S, ©edová L, Oliąarová V, Prokeąová R, Adámkova V, et al. (2015). The importance of self-management in the prevention and treatment of excessive weight and obesity. Neuro Endocrinol Lett 36 (Suppl. 2): 5-10.
    26. Tureto-Borges F, Jenner B, Costa-Hong V, Lopes HF, Teixeira SH, Marum E, et al. (2018). Does obstructive sleep apnea influence blood pressure and arterial stiffness in response to antihypertensive treatment? Hypertension 120(4): 615-627. DOI: 10.1161/HYPERTENSIONAHA.118.10825. Go to original source... Go to PubMed...
    27. Vozoris NT (2012). Sleep apnea-plus: prevalence, risk factors, and association with cardiovascular diseases using United States population-level data. Sleep Med 13(6): 637-644. DOI: 10.1016/j.sleep.2012.01.004. Go to original source... Go to PubMed...
    28. Williams B, Boyle M, Robertson N, Giddings C (2013). When pressure is positive: a literature review of the prehospital use of continuous positive airway pressure. Prehosp Disaster Med 28(1): 52-60. DOI: 10.1017/S1049023X12001562. Go to original source... Go to PubMed...

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content