分夜、通宵和家庭自动滴定CPAP滴定压：中重度阻塞性睡眠呼吸暂停患者的前瞻性比较分析

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-03-08 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S487341

Song I Park, Woori Choi, ChangHee Lee, Hyo Yeol Kim, Yong Gi Jung

{"title":"分夜、通宵和家庭自动滴定CPAP滴定压：中重度阻塞性睡眠呼吸暂停患者的前瞻性比较分析","authors":"Song I Park, Woori Choi, ChangHee Lee, Hyo Yeol Kim, Yong Gi Jung","doi":"10.2147/NSS.S487341","DOIUrl":null,"url":null,"abstract":"Purpose: This prospective study aimed to compare titration pressures obtained using three methods-full-night titration (FN-T), split-night titration (SN-T), and home auto-titration (HA-T)- in patients with moderate to severe obstructive sleep apnea (OSA). Additionally, factors contributing to pressure differences relative to FN-T were investigated.Methods: SN-T was performed on 74 patients suspected of having OSA. Those diagnosed with moderate to severe OSA who completed SN-T underwent HA-T for 2-3 weeks. FN-T was then performed on patients who adhered to HA-T for at least 70% of prescribed nights. Ultimately, 29 patients met the inclusion criteria. Titration pressures from SN-T (SN-TP), HA-T (mean pressure [HA-TPm] and 90th percentile pressure [HA-TP90]), and FN-T (FN-TP) were compared using the Wilcoxon signed-rank test. Patients were classified into pressure disparity and non-disparity groups based on differences between FN-TP and the other methods. Logistic regression analyses were performed to identify factors associated with pressure differences. Baseline characteristics in subgroup analyses were compared using independent t-tests or Mann-Whitney tests for continuous variables and Fisher's exact tests for categorical variables.Results: The titration pressures for SN-TP, FN-TP, HA-TP90, and HA-TPm were 8, 9, 9.6, and 8.1 cm H2O, respectively. All pressures correlated significantly with FN-TP (p < 0.05). HA-TP90 was significantly higher than FN-TP (p < 0.05), while FN-TP was higher than SN-TP (p < 0.05), with similar trends observed at the individual level. Nasal septal deviation (odds ratio 16.63, p = 0.018) and high apnea-hypopnea index (odds ratio 1.06, p = 0.027) were identified as predictors of pressure differences.Conclusion: This study is the first to directly compare multiple titration pressures to standard FN-TP in the same patients. SN-T and HA-T are reliable alternatives to FN-T in moderate to severe OSA, though predictors of significant pressure variance require careful consideration.","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"17 ","pages":"401-412"},"PeriodicalIF":3.0000,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899899/pdf/","citationCount":"0","resultStr":"{\"title\":\"CPAP Titration Pressure in Split-Night, Full-Night, and Home Auto-Titration: A Prospective Comparative Analysis of Patients With Moderate to Severe Obstructive Sleep Apnea.\",\"authors\":\"Song I Park, Woori Choi, ChangHee Lee, Hyo Yeol Kim, Yong Gi Jung\",\"doi\":\"10.2147/NSS.S487341\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Purpose: This prospective study aimed to compare titration pressures obtained using three methods-full-night titration (FN-T), split-night titration (SN-T), and home auto-titration (HA-T)- in patients with moderate to severe obstructive sleep apnea (OSA). Additionally, factors contributing to pressure differences relative to FN-T were investigated.Methods: SN-T was performed on 74 patients suspected of having OSA. Those diagnosed with moderate to severe OSA who completed SN-T underwent HA-T for 2-3 weeks. FN-T was then performed on patients who adhered to HA-T for at least 70% of prescribed nights. Ultimately, 29 patients met the inclusion criteria. Titration pressures from SN-T (SN-TP), HA-T (mean pressure [HA-TPm] and 90th percentile pressure [HA-TP90]), and FN-T (FN-TP) were compared using the Wilcoxon signed-rank test. Patients were classified into pressure disparity and non-disparity groups based on differences between FN-TP and the other methods. Logistic regression analyses were performed to identify factors associated with pressure differences. Baseline characteristics in subgroup analyses were compared using independent t-tests or Mann-Whitney tests for continuous variables and Fisher's exact tests for categorical variables.Results: The titration pressures for SN-TP, FN-TP, HA-TP90, and HA-TPm were 8, 9, 9.6, and 8.1 cm H2O, respectively. All pressures correlated significantly with FN-TP (p < 0.05). HA-TP90 was significantly higher than FN-TP (p < 0.05), while FN-TP was higher than SN-TP (p < 0.05), with similar trends observed at the individual level. Nasal septal deviation (odds ratio 16.63, p = 0.018) and high apnea-hypopnea index (odds ratio 1.06, p = 0.027) were identified as predictors of pressure differences.Conclusion: This study is the first to directly compare multiple titration pressures to standard FN-TP in the same patients. SN-T and HA-T are reliable alternatives to FN-T in moderate to severe OSA, though predictors of significant pressure variance require careful consideration.\",\"PeriodicalId\":18896,\"journal\":{\"name\":\"Nature and Science of Sleep\",\"volume\":\"17 \",\"pages\":\"401-412\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-03-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899899/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nature and Science of Sleep\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/NSS.S487341\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nature and Science of Sleep","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/NSS.S487341","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：本前瞻性研究旨在比较中重度阻塞性睡眠呼吸暂停（OSA）患者采用三种方法(通宵滴定法（FN-T）、分夜滴定法（SN-T）和家庭自动滴定法（HA-T）获得的滴定压力。此外，还研究了与FN-T相关的压力差的影响因素。方法：对74例疑似OSA患者行SN-T治疗。那些被诊断为中度至重度OSA并完成SN-T的患者接受了为期2-3周的HA-T治疗。然后对坚持HA-T至少70%的处方夜的患者进行FN-T。最终，29例患者符合纳入标准。采用Wilcoxon符号秩检验比较SN-T （SN-TP）、HA-T（平均压力[HA-TPm]和第90百分位压力[HA-TP90]）和FN-T （FN-TP）的滴定压力。根据FN-TP与其他方法的差异，将患者分为压力差异组和非压力差异组。进行逻辑回归分析以确定与压力差相关的因素。亚组分析的基线特征采用独立t检验或连续变量的Mann-Whitney检验和分类变量的Fisher精确检验进行比较。结果：SN-TP、FN-TP、HA-TP90、HA-TPm的滴定压力分别为8、9、9.6、8.1 cm H2O。所有压力与FN-TP均有显著相关性（p < 0.05）。HA-TP90显著高于FN-TP (p < 0.05)， FN-TP显著高于SN-TP (p < 0.05)，个体水平差异无统计学意义。鼻中隔偏曲（优势比16.63,p = 0.018）和高呼吸暂停低通气指数（优势比1.06,p = 0.027）被确定为压力差的预测因素。结论：本研究首次将同一患者的多次滴定压与标准FN-TP进行直接比较。在中度至重度OSA患者中，SN-T和HA-T是FN-T的可靠替代品，但需要仔细考虑显著压力变化的预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

CPAP Titration Pressure in Split-Night, Full-Night, and Home Auto-Titration: A Prospective Comparative Analysis of Patients With Moderate to Severe Obstructive Sleep Apnea.

Purpose: This prospective study aimed to compare titration pressures obtained using three methods-full-night titration (FN-T), split-night titration (SN-T), and home auto-titration (HA-T)- in patients with moderate to severe obstructive sleep apnea (OSA). Additionally, factors contributing to pressure differences relative to FN-T were investigated.

Methods: SN-T was performed on 74 patients suspected of having OSA. Those diagnosed with moderate to severe OSA who completed SN-T underwent HA-T for 2-3 weeks. FN-T was then performed on patients who adhered to HA-T for at least 70% of prescribed nights. Ultimately, 29 patients met the inclusion criteria. Titration pressures from SN-T (SN-TP), HA-T (mean pressure [HA-TPm] and 90th percentile pressure [HA-TP90]), and FN-T (FN-TP) were compared using the Wilcoxon signed-rank test. Patients were classified into pressure disparity and non-disparity groups based on differences between FN-TP and the other methods. Logistic regression analyses were performed to identify factors associated with pressure differences. Baseline characteristics in subgroup analyses were compared using independent t-tests or Mann-Whitney tests for continuous variables and Fisher's exact tests for categorical variables.

Results: The titration pressures for SN-TP, FN-TP, HA-TP90, and HA-TPm were 8, 9, 9.6, and 8.1 cm H₂O, respectively. All pressures correlated significantly with FN-TP (p < 0.05). HA-TP90 was significantly higher than FN-TP (p < 0.05), while FN-TP was higher than SN-TP (p < 0.05), with similar trends observed at the individual level. Nasal septal deviation (odds ratio 16.63, p = 0.018) and high apnea-hypopnea index (odds ratio 1.06, p = 0.027) were identified as predictors of pressure differences.

Conclusion: This study is the first to directly compare multiple titration pressures to standard FN-TP in the same patients. SN-T and HA-T are reliable alternatives to FN-T in moderate to severe OSA, though predictors of significant pressure variance require careful consideration.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.