Abstract
Objectives: Describe clinical and polysomnographic characteristics in patients with CSA that require treatment with ASV in our center.
Material and Methods: Descriptive study of 26 patients diagnosed of CSA who were admitted in our Multidisciplinary Sleep Unit MDSU at Fundación Jiménez Díaz-Madrid from May 2009 to November 2011. All patients were treated with CPAP and had gone through a manual titration PSG at 1 or 3 months after diagnosis. We detected poor control and switched to ASV.
Results: Included 26 males patients CSA(age of 61 years and mean BMI of 32.5). CV risk factors:73% ex-smokers,73% HAP 50% lipid alterations,31% ischemic cardiopathy,23% had previous HF,27% arrhythmias,25% DM,7% opioid use,7% chronic renal disease. The classic OSAS triad was the most frequent symptomatology, average Epworth 11,80%.PSG results: average AHI 67/h,CAI 38.4/h,HI 22.6/h,AHI REM 43.2/h.CPAP titration PSG showed a high persisting AHI(average 40.4/h) with predominance of central events(average 23.7/h apnea and 15.1/h hypopnea).ASV was administrated with 2 types of equipment:BIPAP autoSVAor CS2.ASV titration PSG showed a statistically significant decrease in respiratory events with a residual average AHI of 11.3/h(p 0.001),CAI of 0.5/h(p 0.002) and HI of 9/h(p 0.02).The average time of therapeutic compliance was of 6.1/h/night.It statistically improved Epworth score(average of 7.8)(p 0.001).
Conclusions: In our studied HF was not highly prevalent.ASV is an effective therapeutic tool for CSA's and CPAP refractory/resistant compSAS, controlling both apneic events and symptoms. A manual titration PSG is necessary for correct diagnosis and follow-up of these patients.
- © 2012 ERS