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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Does the severity of obstructive sleep apnea predict patients requiring high continuous positive airway pressure?
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Does the severity of obstructive sleep apnea predict patients requiring high continuous positive airway pressure?

机译：阻塞性睡眠呼吸暂停的严重程度是否预示了需要持续高气道正压通气的患者？

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摘要

STUDY OBJECTIVES: To investigate polysomnographic and anthropomorphic factors predicting need of high optimal continuous positive airway pressure (CPAP). DESIGN: Retrospective data analysis. PATIENTS: Three hundred fifty-three consecutive obstructive sleep apnea (OSA) patients who had a successful manual CPAP titration in our sleep disorders unit. MEASUREMENTS AND RESULTS: The mean optimal CPAP was 9.5 +/- 2.4 cm H2O. The optimal CPAP pressure increases with an increase in OSA severity from 7.79 +/- 2.2 in the mild, to 8.7 +/- 1.8 in the moderate, and to 10.1 +/- 2.3 cm H2O in the severe OSA group. A high CPAP was defined as the mean + 1 standard deviation (SD; > or =12 cm H2O). The predictor variables included apnea-hypopnea index (AHI), age, sex, body mass index (BMI), Epworth Sleepiness Scale (ESS), and the Multiple Sleep Latency Test (MSLT). High CPAP was required in 2 (6.9%), 6 (5.8%), and 63 (28.6%) patients with mild, moderate, and severe OSA, respectively. On univariate analysis, AHI, BMI, ESS score, and the proportion of males were significantly higher in those needing high CPAP. They also have a lower MSLT mean. On logistic regression, the use of high CPAP was 5.90 times more frequent (95% confidence interval 2.67-13.1) in severe OSA patients after adjustment for the other variables. The area under the receiver operator curve was 72.4%, showing that the model was adequate. CONCLUSIONS: Severe OSA patients are much more likely to need high CPAP levels. However, because of the low positive predictive value (only 28.6%), the clinical value of such information is limited. ESS and MSLT did not increase the predictive value for the need for high CPAP.
机译：研究目的：研究多导睡眠图和拟人化因素，预测需要高最佳持续气道正压通气（CPAP）。设计：回顾性数据分析。患者：在我们的睡眠障碍部门中，成功进行了手动CPAP滴定的353例连续阻塞性睡眠呼吸暂停（OSA）患者。测量和结果：平均最佳CPAP为9.5 +/- 2.4 cm H2O。最佳CPAP压力随着OSA严重程度的增加而增加，从轻度的7.79 +/- 2.2增加到中度的8.7 +/- 1.8，重度OSA组增加到10.1 +/- 2.3 cm H2O。高CPAP定义为平均值+ 1标准偏差（SD;>或= 12 cm H2O）。预测变量包括呼吸暂停低通气指数（AHI），年龄，性别，体重指数（BMI），爱泼华嗜睡量表（ESS）和多重睡眠潜伏期测验（MSLT）。分别有2名（6.9％），6名（5.8％）和63名（28.6％）患有轻度，中度和重度OSA的患者需要较高的CPAP。单因素分析显示，在需要高CPAP的人群中，AHI，BMI，ESS评分和男性比例明显更高。他们的MSLT平均值也较低。经逻辑回归，校正其他变量后，重度OSA患者使用高CPAP的频率高5.90倍（95％置信区间2.67-13.1）。接收者算子曲线下的面积为72.4％，表明该模型是足够的。结论：严重的OSA患者更有可能需要较高的CPAP水平。但是，由于阳性预测值较低（仅为28.6％），因此此类信息的临床价值有限。 ESS和MSLT并未增加对高CPAP需求的预测价值。

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