Periodic limb movement in sleep before and after continuous positive airway pressure titration in obstructive sleep-apnea patients

IF 0.2 Q4 RESPIRATORY SYSTEM
Lamees M. Bakkar, Reham Elmorshedy, S. Farghaly
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引用次数: 0

Abstract

Background Periodic limb movement during sleep (PLMS) could exist with patients diagnosed as obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) is the most competent therapy for OSA. However, its effect on PLM remains controversial. Aim To evaluate PLMS prevalence in OSA patients and the impact of CPAP titration on PLM outcome. Patients and methods Patients with history suggestive of OSA underwent full attended diagnostic and CPAP titration sleep study. On baseline polysomnography, OSA patients with PLM less than 5 were considered pure OSA and those with periodic limb-movement index more than or equal to 5 were considered combined group. Post-CPAP titration, patients were considered CPAP responders, CPAP persistent, CPAP emergent, or non-PLM group according to response of PLM. Results Out of 100 included OSA patients, the combined group was found in 53 patients. CPAP responder group was reported in 27 patients, while 25 and 24 patients were considered CPAP persistent and CPAP emergent, respectively. CPAP-emergent group showed significantly higher apnea–hypopnea index (AHI) than non-PLM group on baseline polysomnography. On the other hand, AHI was comparable in CPAP-persistent and responder group, despite normalization of AHI in both groups after titration. On multivariate regression analysis, old age was found to be an independent predictor for both persistence and emergence of PLM and higher AHI was an independent predictor in CPAP-emergent group. Conclusion PLMS can coexist with OSA in old-age patients, which may persist after CPAP titration. Elderly patients, especially those with baseline higher AHI, may also present with CPAP-emergent PLMS.
阻塞性睡眠呼吸暂停患者持续气道正压滴定前后睡眠中的周期性肢体运动
背景阻塞性睡眠呼吸暂停(OSA)患者可能存在睡眠期间周期性肢体运动(PLMS)。持续气道正压通气(CPAP)是OSA最有效的治疗方法。然而,它对PLM的影响仍然存在争议。目的探讨阻塞性睡眠呼吸暂停(OSA)患者PLM的患病率及CPAP滴定对PLM预后的影响。患者与方法对有OSA病史的患者进行全程陪同的诊断和CPAP滴定睡眠研究。在基线多导睡眠图中,PLM小于5的OSA患者为单纯OSA,周期性肢体运动指数大于等于5的OSA患者为联合组。CPAP滴定后,根据患者对PLM的反应分为CPAP应答组、CPAP持续组、CPAP紧急组和非PLM组。结果100例OSA患者中53例为联合用药组。27例患者报告了CPAP应答组,而25例和24例患者分别被认为是持续CPAP和紧急CPAP。基线多导睡眠图显示,cpap急救组呼吸暂停低通气指数(AHI)明显高于非plm组。另一方面,尽管两组在滴定后AHI恢复正常,但cpap持续组和反应组的AHI具有可比性。多因素回归分析发现,年龄是PLM持续和出现的独立预测因子,而较高的AHI是cpap出现组的独立预测因子。结论老年患者PLMS可与OSA共存,并可在CPAP滴定后持续存在。老年患者,尤其是基线AHI较高的患者,也可能出现cpap引发的PLMS。
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来源期刊
自引率
0.00%
发文量
46
审稿时长
22 weeks
期刊介绍: The journal will cover technical and clinical studies related to health, ethical and social issues in field of The Egyptian Journal of Chest Diseases and Tuberculosis aims to publish and inform readers and all chest physicians of the progress in medical research concerning all aspect of chest diseases. Publications include original articles review articles, editorials, case studies and reports which are relevant to chest diseases. The Journal also aims to highlight recent updates in chest medicine. . Articles with clinical interest and implications will be given preference.
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