Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16784
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dc.contributor.authorLandry, Shane A-
dc.contributor.authorJoosten, Simon A-
dc.contributor.authorEckert, Danny J-
dc.contributor.authorJordan, Amy S-
dc.contributor.authorSands, Scott A-
dc.contributor.authorWhite, David P-
dc.contributor.authorMalhotra, Atul -
dc.contributor.authorWellman, Andrew -
dc.contributor.authorHamilton, Garun S-
dc.contributor.authorEdwards, Bradley A-
dc.date.accessioned2017-08-10T01:16:56Z-
dc.date.available2017-08-10T01:16:56Z-
dc.date.issued2017-06-01-
dc.identifier.citationSleep 2017; 40(6): zsx056en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/16784-
dc.description.abstractSTUDY OBJECTIVES: Upper airway collapsibility is a key determinant of obstructive sleep apnea (OSA) which can influence the efficacy of certain non-continuous positive airway pressure (CPAP) treatments for OSA. However, there is no simple way to measure this variable clinically. The present study aimed to develop a clinically implementable tool to evaluate the collapsibility of a patient's upper airway. METHODS: Collapsibility, as characterized by the passive pharyngeal critical closing pressure (Pcrit), was measured in 46 patients with OSA. Associations were investigated between Pcrit and data extracted from patient history and routine polysomnography, including CPAP titration. RESULTS: Therapeutic CPAP level, demonstrated the strongest relationship to Pcrit (r2=0.51, p < .001) of all the variables investigated including apnea-hypopnea index, body mass index, sex, and age. Patients with a mildly collapsible upper airway (Pcrit ≤ -2 cmH2O) had a lower therapeutic CPAP level (6.2 ± 0.6 vs. 10.3 ± 0.4 cmH2O, p < .001) compared to patients with more severe collapsibility (Pcrit > -2 cmH2O). A therapeutic CPAP level ≤8.0 cmH2O was sensitive (89%) and specific (84%) for detecting a mildly collapsible upper airway. When applied to the independent validation data set (n = 74), this threshold maintained high specificity (91%) but reduced sensitivity (75%). CONCLUSIONS: Our data demonstrate that a patient's therapeutic CPAP requirement shares a strong predictive relationship with their Pcrit and may be used to accurately differentiate OSA patients with mild airway collapsibility from those with moderate-to-severe collapsibility. Although this relationship needs to be confirmed prospectively, our findings may provide clinicians with better understanding of an individual patient's OSA phenotype, which ultimately could assist in determining which patients are most likely to respond to non-CPAP therapies.en_US
dc.subjectCPAPen_US
dc.subjectObstructive sleep apneaen_US
dc.subjectPcriten_US
dc.subjectCollapsibilityen_US
dc.subjectPhenotypingen_US
dc.titleTherapeutic CPAP level predicts upper airway collapsibility in patients with obstructive sleep apneaen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleSleepen_US
dc.identifier.affiliationInstitute for Breathing and Sleepen_US
dc.identifier.affiliationSleep and Circadian Medicine Laboratory, Department of Physiology, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationSchool of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationSchool of Clinical Sciences, Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationMonash Partners - Epworth, Melbourne, Australiaen_US
dc.identifier.affiliationDivision of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MAen_US
dc.identifier.affiliationNeuroscience Research Australia (NeuRA) and the University of New South Wales, Randwick, Sydney, New South Wales, Australiaen_US
dc.identifier.affiliationMelbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Allergy, Immunology and Respiratory Medicine and Central Clinical School, The Alfred and Monash University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationDivision of Pulmonary and Critical Care Medicine, University of California San Diego, CAen_US
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/28419320en_US
dc.identifier.doi10.1093/sleep/zsx056en_US
dc.type.contentTexten_US
dc.type.austinJournal Articleen_US
local.name.researcherJordan, Amy S
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.openairetypeJournal Article-
crisitem.author.deptRespiratory and Sleep Medicine-
crisitem.author.deptInstitute for Breathing and Sleep-
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