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Predicting Continuous Positive Airway Pressure from a Modified Split-Night Protocol in Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome
Open accessAbstract
BACKGROUND: Most split-night sleep (SNS) studies have enrolled Caucasian patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome (OSAHS), with different apnea-hypopnea index (AHI) criteria for diagnosis and successful CPAP titration from the standard full-night study (FNS). This study aimed to describe a shortened diagnostic SNS in the Taiwanese population using diagnostic and CPAP therapeutic criteria identical to the standard FNS, and to generate a predictive equation for effective CPAP (Peff) titration. METHODS: A total of 418 patients with moderate-to-severe OSAHS were enrolled in this study. The duration of the diagnostic SNS was shortened to approximately 1-2 hours. The diagnostic accuracy and the success rate of CPAP titration in SNS were evaluated and a statistical model for Peff was built. The accuracy of the predictive equation was validated in another 127 patients. RESULTS: Eighty-nine percent of patients with moderate-to-severe OSAHS diagnosed in the preceding FNS yielded the same grade of OSAHS in SNS. These reproducible patients were more severe, with 88% attaining successful CPAP titration in SNS. The predictive Peff=1.98+0.184xBMI+0.01xAHISNS +0.016xDISNS (R2=0.28, p<0.0001) where BMI was the body mass index and DI the desaturation index. The | predictive Peff- Peff | was within 2 cm H(2)O in 84% of the study group and 73% of the validation group. CONCLUSION: The modified split-night protocol and the predictive equation for CPAP can be useful in Taiwanese patients with moderate-to-severe OSAHS. Our findings may shorten the waiting time for polysomnography.
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“Another study showed an AHI Pearson correlation coefficient between a full-night study and the diagnostic portion of the split-night study of 0.63 when the split-night study recording time was ≥ 90 minutes.123”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [123]
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“Four studies that examined diagnostic accuracy and performance characteristics of a split-night protocol used the initial truncated PSG to serve as a representative surrogate of the initial diagnostic portion of a split-night study; the first 2–3 hours of the recording were compared to the full night of sleep recording.121–123,127”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [123]
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“Our literature search yielded nine studies that met inclusion criteria.112,121–128”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [123]
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Cited by
Sorted by citations
Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6506 · Cited by 3,253
Metadata
- Authors
- Chuang, M.-L., Lin, I.-F., Vintch, J. R. E., & Liao, Y.-F.
- Affiliations
- China Medical University (TW)
- National Yang Ming University (TW)
- Harbor–UCLA Medical Center (US)
- Chang Gung Memorial Hospital (TW)
- Venue
- Internal Medicine
- Published
- 2008
- Volume
- 47
- Issue
- 18
- Pages
- 1585-1592
- ISSN
- 0918-2918 (ISSN-L)
- 1349-7235
- OpenAlex
- W2070862922
- Cited by
- 17
- References
- 0
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 3 · 2021: 4 · 2020: 1 · 2018: 1 · 2017: 1 · 2015: 1 · 2014: 1
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Council
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- obstructive sleep apnea-hypopnea syndrome, CPAP titration, diagnostic accuracy, body mass index, desaturation index, apnea-hypopnea index, Taiwanese patients
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Taiwan, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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