A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China

Abstract Background Numerous predictive formulas based on different ethnics have been developed to determine continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea (OSA) without laboratory-based manual titrations. However, few studies have focused on patients with OSA i...

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Main Authors: Le Wang, Xing Chen, Dong-hui Wei, Mao-li Liang, Yan Wang, Bao-yuan Chen, Jing Zhang, Jie Cao
Format: Article
Language:English
Published: BMC 2022-06-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-022-02025-8
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author Le Wang
Xing Chen
Dong-hui Wei
Mao-li Liang
Yan Wang
Bao-yuan Chen
Jing Zhang
Jie Cao
author_facet Le Wang
Xing Chen
Dong-hui Wei
Mao-li Liang
Yan Wang
Bao-yuan Chen
Jing Zhang
Jie Cao
author_sort Le Wang
collection DOAJ
description Abstract Background Numerous predictive formulas based on different ethnics have been developed to determine continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea (OSA) without laboratory-based manual titrations. However, few studies have focused on patients with OSA in China. Therefore, this study aimed to develop a predictive equation for determining the optimal value of CPAP for patients with OSA in China. Methods 526 pure moderate to severe OSA patients with attended CPAP titrations during overnight polysomnogram were spited into either formula derivation (419 patients) or validation (107 patients) group according to the treatment time. Predictive model was created in the derivation group, and the accuracy of the model was tested in the validation group. Results Apnea hypopnea index (AHI), body mass index (BMI), longest apnea time (LAT), and minimum percutaneous oxygen saturation (minSpO2) were considered as independent predictors of optimal CPAP through correlation analysis and multiple stepwise regression analysis. The best equation to predict the optimal value of CPAP was: CPAPpred = 7.581 + 0.020*AHI + 0.101*BMI + 0.015*LAT-0.028*minSpO2 (R2 = 27.2%, p < 0.05).The correlation between predictive CPAP and laboratory-determined manual optimal CPAP was significant in the validation group (r = 0.706, p = 0.000). And the pressure determined by the predictive formula did not significantly differ from the manually titrated pressure in the validation cohort (10 ± 1 cmH2O vs. 11 ± 3 cmH2O, p = 0.766). Conclusions The predictive formula based on AHI, BMI, LAT, and minSpO2 is useful in calculating the effective CPAP for patients with pure moderate to severe OSA in China to some extent.
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spelling doaj.art-248611449f32463b890e1436e98f5bbe2022-12-22T03:31:07ZengBMCBMC Pulmonary Medicine1471-24662022-06-012211810.1186/s12890-022-02025-8A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in ChinaLe Wang0Xing Chen1Dong-hui Wei2Mao-li Liang3Yan Wang4Bao-yuan Chen5Jing Zhang6Jie Cao7Department of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalDepartment of Respiratory and Critical Care Medicine, Tianjin Medical University General HospitalAbstract Background Numerous predictive formulas based on different ethnics have been developed to determine continuous positive airway pressure (CPAP) for patients with obstructive sleep apnea (OSA) without laboratory-based manual titrations. However, few studies have focused on patients with OSA in China. Therefore, this study aimed to develop a predictive equation for determining the optimal value of CPAP for patients with OSA in China. Methods 526 pure moderate to severe OSA patients with attended CPAP titrations during overnight polysomnogram were spited into either formula derivation (419 patients) or validation (107 patients) group according to the treatment time. Predictive model was created in the derivation group, and the accuracy of the model was tested in the validation group. Results Apnea hypopnea index (AHI), body mass index (BMI), longest apnea time (LAT), and minimum percutaneous oxygen saturation (minSpO2) were considered as independent predictors of optimal CPAP through correlation analysis and multiple stepwise regression analysis. The best equation to predict the optimal value of CPAP was: CPAPpred = 7.581 + 0.020*AHI + 0.101*BMI + 0.015*LAT-0.028*minSpO2 (R2 = 27.2%, p < 0.05).The correlation between predictive CPAP and laboratory-determined manual optimal CPAP was significant in the validation group (r = 0.706, p = 0.000). And the pressure determined by the predictive formula did not significantly differ from the manually titrated pressure in the validation cohort (10 ± 1 cmH2O vs. 11 ± 3 cmH2O, p = 0.766). Conclusions The predictive formula based on AHI, BMI, LAT, and minSpO2 is useful in calculating the effective CPAP for patients with pure moderate to severe OSA in China to some extent.https://doi.org/10.1186/s12890-022-02025-8Obstructive sleep apneaContinuous positive airway pressurePredictive model
spellingShingle Le Wang
Xing Chen
Dong-hui Wei
Mao-li Liang
Yan Wang
Bao-yuan Chen
Jing Zhang
Jie Cao
A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China
BMC Pulmonary Medicine
Obstructive sleep apnea
Continuous positive airway pressure
Predictive model
title A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China
title_full A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China
title_fullStr A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China
title_full_unstemmed A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China
title_short A predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in China
title_sort predictive model for optimal continuous positive airway pressure in the treatment of pure moderate to severe obstructive sleep apnea in china
topic Obstructive sleep apnea
Continuous positive airway pressure
Predictive model
url https://doi.org/10.1186/s12890-022-02025-8
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