Clinical predictors of effective continuous positive airway pressure in patients with obstructive sleep apnea/hypopnea syndrome

Abstract

Objectives/Hypothesis To identify standard clinical parameters that may predict the optimal level of continuous positive airway pressure (CPAP) in adult patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Study Design This is a retrospective study in a tertiary academic medical center that included 129 adult patients (117 males and 12 females) with OSAHS confirmed by diagnostic polysomnography (PSG). Methods All OSAHS patients underwent successful full-night manual titration to determine the optimal CPAP pressure level for OSAHS treatment. The PSG parameters and completed physical examination, including body mass index, tonsil size grading, modified Mallampati grade (also known as updated Friedman's tongue position [uFTP]), uvular length, neck circumference, waist circumference, hip circumference, thyroid-mental distance, and hyoid-mental distance (HMD) were recorded. Results When the physical examination variables and OSAHS disease were correlated singly with the optimal CPAP pressure, we found that uFTP, HMD, and apnea/hypopnea index (AHI) were reliable predictors of CPAP pressures (P = .013, P = .002, and P