Sleep & breathing = Schlaf & Atmung
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Comparative Study
Analysis of cardiopulmonary coupling to assess adaptive servo-ventilation success in complex sleep apnea management.
Adaptive servo-ventilation (ASV) is used to treat complex sleep apnea syndrome (CompSAS), but with variable success. Factors influencing success are poorly understood. ASV devices determine their output based upon characteristics of a given breath and on proprietary algorithms that assume a periodic breathing pattern. Periodic breathing patterns produce elevated narrow band low-frequency cardiopulmonary coupling (eNB-LFC). Therefore, we hypothesized that ASV success would correlate with elevated proportions of periodic breathing as marked by eNB-LFC on cardiopulmonary coupling (CPC) analysis. ⋯ ASV was successful in 81 % of patients with CompSAS. However, eNB-LFC calculated from CPC, a marker for periodic breathing, did not correlate with ASV success and therefore may not be a useful tool to predict ASV success.
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Sleep-disordered breathing (SDB) differs between genders in terms of the type, signs, and symptoms of the disease. Partial upper airway obstruction is underdiagnosed and undertreated. ⋯ These results indicate that partial upper airway obstruction in women should be clinically recognized like obstructive sleep apnea.
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Positional obstructive sleep apnoea (POSA), defined as a supine apnoea-hypopnoea index (AHI) twice or more as compared to the AHI in the other positions, occurs in 56 % of obstructive sleep apnoea patients. Positional therapy (PT) is one of several available treatment options for these patients. So far, PT has been hampered by compliance problems, mainly because of the usage of bulky masses placed in the back. In this article, we present a novel device for treating POSA patients. ⋯ The Sleep Position Trainer applied for 1 month is a highly successful and well-tolerated treatment for POSA patients, which diminishes subjective sleepiness and improves sleep-related quality of life without negatively affecting sleep efficiency. Further research, especially on long-term effectiveness, is ongoing.