Show simple item record

dc.contributor.authorMoro, Marilynen_US
dc.contributor.authorGannon, Karenen_US
dc.contributor.authorLovell, Kathyen_US
dc.contributor.authorMerlino, Margareten_US
dc.contributor.authorMojica, Jamesen_US
dc.contributor.authorBianchi, Matt Ten_US
dc.date.accessioned2016-10-11T20:26:54Z
dc.date.issued2016en_US
dc.identifier.citationMoro, Marilyn, Karen Gannon, Kathy Lovell, Margaret Merlino, James Mojica, and Matt T Bianchi. 2016. “Clinical predictors of central sleep apnea evoked by positive airway pressure titration.” Nature and Science of Sleep 8 (1): 259-266. doi:10.2147/NSS.S110032. http://dx.doi.org/10.2147/NSS.S110032.en
dc.identifier.issn1179-1608en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:29002560
dc.description.abstractPurpose Treatment-emergent central sleep apnea (TECSA), also called complex apnea, occurs in 5%–15% of sleep apnea patients during positive airway pressure (PAP) therapy, but the clinical predictors are not well understood. The goal of this study was to explore possible predictors in a clinical sleep laboratory cohort, which may highlight those at risk during clinical management. Methods: We retrospectively analyzed 728 patients who underwent PAP titration (n=422 split-night; n=306 two-night). Demographics and self-reported medical comorbidities, medications, and behaviors as well as standard physiological parameters from the polysomnography (PSG) data were analyzed. We used regression analysis to assess predictors of binary presence or absence of central apnea index (CAI) ≥5 during split-night PSG (SN-PSG) versus full-night PSG (FN-PSG) titrations. Results: CAI ≥5 was present in 24.2% of SN-PSG and 11.4% of FN-PSG patients during titration. Male sex, maximum continuous positive airway pressure, and use of bilevel positive airway pressure were predictors of TECSA, and rapid eye movement dominance was a negative predictor, for both SN-PSG and FN-PSG patients. Self-reported narcotics were a positive predictor of TECSA, and the time spent in stage N2 sleep was a negative predictor only for SN-PSG patients. Self-reported history of stroke and the CAI during the diagnostic recording predicted TECSA only for FN-PSG patients. Conclusion: Clinical predictors of treatment-evoked central apnea spanned demographic, medical history, sleep physiology, and titration factors. Improved predictive models may be increasingly important as diagnostic and therapeutic modalities move away from the laboratory setting, even as PSG remains the gold standard for characterizing primary central apnea and TECSA.en
dc.language.isoen_USen
dc.publisherDove Medical Pressen
dc.relation.isversionofdoi:10.2147/NSS.S110032en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968988/pdf/en
dash.licenseLAAen_US
dc.subjectrisken
dc.subjectpredictionen
dc.subjectcentral apneaen
dc.subjectcomplex apneaen
dc.subjectemergenten
dc.subjecttitrationen
dc.titleClinical predictors of central sleep apnea evoked by positive airway pressure titrationen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalNature and Science of Sleepen
dash.depositing.authorMojica, Jamesen_US
dc.date.available2016-10-11T20:26:54Z
dc.identifier.doi10.2147/NSS.S110032*
dash.contributor.affiliatedMojica, James
dash.contributor.affiliatedBianchi, Matt Travis


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record