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Keywords = auto-titrating continuous positive airway pressure

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16 pages, 729 KiB  
Review
Long-Term Management of Sleep Apnea-Hypopnea Syndrome: Efficacy and Challenges of Continuous Positive Airway Pressure Therapy—A Narrative Review
by Zishan Rahman, Ahsan Nazim, Palvi Mroke, Khansa Ali, MD Parbej Allam, Aakash Mahato, Mahveer Maheshwari, Camila Sanchez Cruz, Imran Baig and Ernesto Calderon Martinez
Med. Sci. 2025, 13(1), 4; https://doi.org/10.3390/medsci13010004 - 30 Dec 2024
Cited by 1 | Viewed by 2623
Abstract
Sleep apnea-hypopnea syndrome (SAHS) is a respiratory disorder characterized by cessation of breathing during sleep, resulting in daytime somnolence and various comorbidities. SAHS encompasses obstructive sleep apnea (OSA), caused by upper airway obstruction, and central sleep apnea (CSA), resulting from lack of brainstem [...] Read more.
Sleep apnea-hypopnea syndrome (SAHS) is a respiratory disorder characterized by cessation of breathing during sleep, resulting in daytime somnolence and various comorbidities. SAHS encompasses obstructive sleep apnea (OSA), caused by upper airway obstruction, and central sleep apnea (CSA), resulting from lack of brainstem signaling for respiration. Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for SAHS, reducing apnea and hypopnea episodes by providing continuous airflow. CPAP enhances sleep quality and improves overall health by reducing the risk of comorbidities such as hypertension, type 2 diabetes mellitus, cardiovascular disease and stroke. CPAP nonadherence leads to health deterioration and occurs due to mask discomfort, unsupportive partners, upper respiratory dryness, and claustrophobia. Technological advancements such as auto-titrating positive airway pressure (APAP) systems, smart fit mask interface systems, and telemonitoring devices offer patients greater comfort and enhance adherence. Future research should focus on new technological developments, such as artificial intelligence, which may detect treatment failure and alert providers to intervene accordingly. Full article
(This article belongs to the Section Pneumology and Respiratory Diseases)
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7 pages, 414 KiB  
Article
The Use of Auto-Titrating Continuous Positive Airway Pressure (AutoCPAP) for Obstructive Sleep Apnea Syndrome in Children with Obesity
by Sarah Benke, Caroline U. A. Okorie and MaryAnne A. Tablizo
Children 2021, 8(12), 1204; https://doi.org/10.3390/children8121204 - 19 Dec 2021
Cited by 2 | Viewed by 3675
Abstract
Background: Positive airway pressure can be an effective and safe therapy for children with obstructive sleep apnea syndrome (OSAS). Few studies have assessed the safety and efficacy of autoCPAP in pediatric patients with obesity. Methods: This was a retrospective chart review of children [...] Read more.
Background: Positive airway pressure can be an effective and safe therapy for children with obstructive sleep apnea syndrome (OSAS). Few studies have assessed the safety and efficacy of autoCPAP in pediatric patients with obesity. Methods: This was a retrospective chart review of children with obesity (Body Mass Index (BMI) > 99th percentile), ages 2–18, diagnosed with OSAS (Obstructive Apnea-Hypopnea Index (OAHI) > 1/h) and used autoCPAP with 30-day adherence. Exclusion criteria included patients with complex comorbidities. Adherence was defined as autoCPAP use ≥4 h/night for at least 21/30 days. Baseline PSG OAHI was compared to the AHI from the 30-day autoCPAP compliance report. We also compared autoCPAP 30-day 95th percentile pressures with the pressures from PAP titration. Results: The study included 19 children, ranging 5–15 years old. The median BMI was 99.6th percentile and average adherence was 25/30 nights with mean of 7.3 h/night. The median OAHI was 12.3/h on baseline PSG and the 30-day autoCPAP download AHI decreased to 1.7/h. No adverse outcomes were identified. The average difference between 95th percentile autoCPAP pressure and PAP titration pressure was 0.89 cmH20. Conclusion: Our study suggests autoCPAP is effective and safe for the treatment of OSAS in pediatric patients with obesity. Using autoCPAP may reduce delays in treatment. Additional research is needed to verify the long-term effectiveness of autoCPAP in this population. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
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13 pages, 2347 KiB  
Review
Positive Airway Pressure Therapy for Pediatric Obstructive Sleep Apnea
by Kelly K. Hady and Caroline U. A. Okorie
Children 2021, 8(11), 979; https://doi.org/10.3390/children8110979 - 29 Oct 2021
Cited by 7 | Viewed by 6411
Abstract
Pediatric obstructive sleep apnea syndrome (OSAS) is a disorder of breathing during sleep, characterized by intermittent or prolonged upper airway obstruction that can disrupt normal ventilation and/or sleep patterns. It can affect an estimated 2–4% of children worldwide. Untreated OSAS can have far [...] Read more.
Pediatric obstructive sleep apnea syndrome (OSAS) is a disorder of breathing during sleep, characterized by intermittent or prolonged upper airway obstruction that can disrupt normal ventilation and/or sleep patterns. It can affect an estimated 2–4% of children worldwide. Untreated OSAS can have far reaching consequences on a child’s health, including low mood and concentration as well as metabolic derangements and pulmonary vascular disease. Most children are treated with surgical intervention (e.g., first-line therapy, adenotonsillectomy); however, for those for whom surgery is not indicated or desired, or for those with postoperative residual OSAS, positive airway pressure (PAP) therapy is often employed. PAP therapy can be used to relieve upper airway obstruction as well as aid in ventilation. PAP therapy is effective in treatment of OSAS in children and adults, although with pediatric patients, additional considerations and limitations exist. Active management and care for various considerations important to pediatric patients with OSAS can allow PAP to be an effective and safe therapy in this population. Full article
(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome in Children)
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6 pages, 242 KiB  
Article
An Inpatient Program for Diagnosing and Treating Sleep Apnea in Patients with Stroke
by Xiaoshu Cao, Cary Fan and T Douglas Bradley
Clin. Transl. Neurosci. 2018, 2(2), 27; https://doi.org/10.1177/2514183x18786843 - 21 Aug 2018
Viewed by 614
Abstract
Background and Purpose: Sleep apnea (SA) is highly prevalent in the stroke population. Testing and treating SA in stroke patients is challenging due to inaccessibility to testing and impaired mobility. To address this problem, we designed and implemented an inpatient diagnosis and treatment [...] Read more.
Background and Purpose: Sleep apnea (SA) is highly prevalent in the stroke population. Testing and treating SA in stroke patients is challenging due to inaccessibility to testing and impaired mobility. To address this problem, we designed and implemented an inpatient diagnosis and treatment program for managing SA in patients with stroke. Our main aim in this article is to assess the feasibility of this program. Methods: We tested 83 patients with a portable SA testing device and initiated treatment with auto-titrating continuous positive airway pressure (A-CPAP) for those who were diagnosed with SA during their stay in an inpatient stroke rehabilitation unit (SRU). Patients diagnosed with SA were given a 2- to 4-week trial of A-CPAP in their hospital bed with close follow-up from a sleep medicine service. Results: Of the 83 patients tested, 54 (67.5%) had SA and 46 (85%) agreed to a trial of A-CPAP therapy. Of the 46 patients, who trialed A-CPAP, 32 (70%) achieved average daily use of four or more hours and went home with it. Conclusions: This program provides a feasible and convenient means of testing and treating SA among stroke patients undergoing inpatient stroke rehabilitation. Full article
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