Linz, Dominik and Malfertheiner, Maximilian Valentin and Werner, Nils and Lerzer, Christoph and Gfuellner, Florian and Linz, Benedikt and Zeman, Florian and McEvoy, R. Doug and Arzt, Michael and Baumert, Mathias (2021) Nocturnal hypoxemic burden during positive airway pressure treatment across different central sleep apnea etiologies. SLEEP MEDICINE, 79. pp. 62-70. ISSN 1389-9457, 1878-5506
Full text not available from this repository. (Request a copy)Abstract
Introduction: Nocturnal hypoxemia is associated with increased cardiovascular mortality. Here, we assess whether positive airway pressure by adaptive servo-ventilation (ASV) reduces nocturnal hypoxemic burden in patients with primary central sleep apnea (primary CSA), or heart failure related central sleep apnea (CSA-HF) and treatment emergent central sleep apnea (TECSA). Methods: Overnight oximetry data from 328 consecutive patients who underwent ASV initiation between March 2010 and May 2018 were retrospectively analyzed. Patients were stratified into three groups: primary CSA (n = 14), CSA-HF (n = 31), TECSA (n = 129). Apnea hypopnea index (AHI) and time spent below 90% SpO(2) (T90) was measured. Additionally, T90 due to acute episodic desaturations (T90(Desaturation)) and due to non-specific and non-cyclic drifts of SpO(2) (T90(Non-specific)) were assessed. Results: ASV reduced the AHI below 15/h in all groups. ASV treatment significantly shortened T90 in all three etiologies to a similar extent. T90(Desaturation), but not T90(Non-specific), was reduced by ASV across all three patient groups. AHI was identified as an independent modulator for Delta T90(Desaturation) upon ASV treatment (B (95% CI: -1.32 (-1.73; -0.91), p < 0.001), but not for Delta T90 or Delta T90(Non-specific). Body mass index was one independent predictor of T90. Conclusions: Across different central sleep apnea etiologies, ASV reduced AHI, but nocturnal hypoxemic burden remained high due to a non-specific component of T90 not related to episodic desaturation. Whether adjunct risk factor management such as weight-loss can further reduce T90 warrants further study. (C) 2021 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; Sleep apnea; Sleep-disordered breathing; Oximetry; Continuous positive airway pressure; Adaptive servo-ventilation; Heart failure |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Sep 2022 10:57 |
| Last Modified: | 16 Sep 2022 10:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47559 |
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