Nesrine Adly Ibrahim, Abdulghani Sankari, A. Aldwaikat, Nishtha Pandya, S. Chowdhuri, A. Salloum, Jennifer L Martin, S. Zeineddine, M. S. Badr
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Diagnostic “CSA only” was defined as AHI ≥ 10 events/ hour and CAI ≥ 50% of AHI. “OSA only” was defined if AHI≥ 10 events/ hour and CAI < 5 events/ hour. Comorbid central and obstructive sleep apnea (COSA) was defined if AHI≥ 10 events/ hour and CAI > 5 events/ hour but <50% of AHI. The responsiveness to PAP therapy was determined based on the CAI < 5 events/h on the titration study.\n \n \n \n A total of 90 patients met the inclusion criteria and from those 64 Veterans were found to have COSA (71%), 18 (20%) were CSA only, and 8 (9%) were OSA only. A total of 22 (24.4%) Veterans diagnosed with CSA or COSA were responsive to PAP therapy. Sixty days after treatment initiation, both responsive and nonresponsive groups had significant decreases in AHI and CAI (p<0.05).\n \n \n \n Comorbid central and obstructive SDB is common among Veterans. 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In this retrospective study, we investigated the prevalence of comorbid central and obstructive SDB and the response rate to PAP among Veterans.\\n \\n \\n \\n Veterans were screened from a single VA medical center who had a polysomnography (PSG) study from 2017-2021 to ascertain the presence, severity, and type of SDB by measuring the Apnea-Hypopnea Index (AHI) and Central Apnea Index (CAI). Patients were excluded if they did not have complete studies (diagnostic and PAP titration studies). The inclusion criteria for these analyses were central sleep apnea (CSA) defined as AHI ≥ 10 events/hour and CAI ≥ 5 events/ hour. Diagnostic “CSA only” was defined as AHI ≥ 10 events/ hour and CAI ≥ 50% of AHI. “OSA only” was defined if AHI≥ 10 events/ hour and CAI < 5 events/ hour. Comorbid central and obstructive sleep apnea (COSA) was defined if AHI≥ 10 events/ hour and CAI > 5 events/ hour but <50% of AHI. 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引用次数: 0
摘要
睡眠呼吸障碍 (SDB) 在退伍军人中很常见。在这项回顾性研究中,我们调查了退伍军人中合并中枢性和阻塞性 SDB 的患病率以及对 PAP 的响应率。 我们从一个退伍军人医疗中心筛选出 2017-2021 年间进行过多导睡眠图(PSG)检查的退伍军人,通过测量呼吸暂停-低通气指数(AHI)和中枢性呼吸暂停指数(CAI)来确定 SDB 的存在、严重程度和类型。如果患者没有完整的研究(诊断和 PAP 滴定研究),则将其排除在外。这些分析的纳入标准是中枢性睡眠呼吸暂停(CSA),即 AHI ≥ 10 次/小时和 CAI ≥ 5 次/小时。诊断性 "仅 CSA "是指 AHI ≥ 10 次/小时且 CAI ≥ AHI 的 50%。如果 AHI ≥ 10 次/小时且 CAI < 5 次/小时,则定义为 "仅 OSA"。如果 AHI ≥ 10 次/小时且 CAI > 5 次/小时但低于 AHI 的 50%,则定义为合并中枢性和阻塞性睡眠呼吸暂停(COSA)。在滴定研究中,根据 CAI < 5 事件/小时来确定对 PAP 治疗的反应性。 共有 90 名患者符合纳入标准,其中 64 名退伍军人(71%)患有 COSA,18 名(20%)仅患有 CSA,8 名(9%)仅患有 OSA。共有 22 名(24.4%)被诊断为 CSA 或 COSA 的退伍军人对 PAP 治疗有反应。治疗开始 60 天后,有反应组和无反应组的 AHI 和 CAI 均显著下降(P<0.05)。 中枢性和阻塞性 SDB 合并症在退伍军人中很常见。对 PAP 治疗的反应并不理想,但随着时间的推移会有所改善。
Prevalence of Central Sleep Apnea among Veterans and Response Rate to Continuous Positive Airway Pressure Therapy
Sleep-disordered breathing (SDB) is common in the Veteran population. In this retrospective study, we investigated the prevalence of comorbid central and obstructive SDB and the response rate to PAP among Veterans.
Veterans were screened from a single VA medical center who had a polysomnography (PSG) study from 2017-2021 to ascertain the presence, severity, and type of SDB by measuring the Apnea-Hypopnea Index (AHI) and Central Apnea Index (CAI). Patients were excluded if they did not have complete studies (diagnostic and PAP titration studies). The inclusion criteria for these analyses were central sleep apnea (CSA) defined as AHI ≥ 10 events/hour and CAI ≥ 5 events/ hour. Diagnostic “CSA only” was defined as AHI ≥ 10 events/ hour and CAI ≥ 50% of AHI. “OSA only” was defined if AHI≥ 10 events/ hour and CAI < 5 events/ hour. Comorbid central and obstructive sleep apnea (COSA) was defined if AHI≥ 10 events/ hour and CAI > 5 events/ hour but <50% of AHI. The responsiveness to PAP therapy was determined based on the CAI < 5 events/h on the titration study.
A total of 90 patients met the inclusion criteria and from those 64 Veterans were found to have COSA (71%), 18 (20%) were CSA only, and 8 (9%) were OSA only. A total of 22 (24.4%) Veterans diagnosed with CSA or COSA were responsive to PAP therapy. Sixty days after treatment initiation, both responsive and nonresponsive groups had significant decreases in AHI and CAI (p<0.05).
Comorbid central and obstructive SDB is common among Veterans. The response to PAP therapy is suboptimal but improves over time.