Useful variables during wake and sleep for prediction of positive airway pressure in obstructive sleep apnea titration

Abstract

Background: Positive airway pressure is the main treatment modality in obstructive sleep apnea. The level of pressure needed for each patient is defined by a positive airway pressure titration study. Predicting those who need higher pressure or bi-level instead of continuous pressure is of a great clinical significance. This study was designed to evaluate whether voluntary breath-holding maneuver could predict Bilevel Positive Airway Pressure (BiPAP) or Continuous Positive Airway Pressure (CPAP) as the final optimal pressure in a split night study of patients with obstructive sleep apnea. Polysomnography (PSG) parameters specially oxygen saturation (SaO 2) during non-rapid eye movement (NREM), rapid eye movement sleep (REM), and duration of REM in diagnostic part may help determine the type of devices as soon as possible in split night study. Methods: The present research was conducted as a cross-sectional study of adults diagnosed as obstructive sleep apnea patients undergoing positive airway pressure (PAP) titration. Demographic, anthropometric, and polysomnographic data were collected. Patients were instructed to hold their breath as long as they could after five tidal breaths in the supine position. Baseline, post breath-holding phase, and recovery SaO 2 were recorded. These data were used to predict the pressure level and type of device.