Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population
CONTEXT: Positive airway pressure (PAP) is the first-line therapy for obstructive sleep apnea (OSA). Overnight PAP titration for determining optimal PAP requirements is expensive and often inconvenient. Prediction of optimal PAP requirements from diagnostic polysomnography via mathematical equations...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Annals of Thoracic Medicine |
| Subjects: | |
| Online Access: | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2023;volume=18;issue=1;spage=31;epage=38;aulast=Bamagoos |
| _version_ | 1797904972864552960 |
|---|---|
| author | Ahmad A Bamagoos Shahad A Alshaynawi Atheer S Gari Atheer M Badawi Mudhawi H Alhiniah Asma A Alshahrani Renad R Rajab Reem K Bahaj Faris Alhejaili Siraj O Wali |
| author_facet | Ahmad A Bamagoos Shahad A Alshaynawi Atheer S Gari Atheer M Badawi Mudhawi H Alhiniah Asma A Alshahrani Renad R Rajab Reem K Bahaj Faris Alhejaili Siraj O Wali |
| author_sort | Ahmad A Bamagoos |
| collection | DOAJ |
| description | CONTEXT: Positive airway pressure (PAP) is the first-line therapy for obstructive sleep apnea (OSA). Overnight PAP titration for determining optimal PAP requirements is expensive and often inconvenient. Prediction of optimal PAP requirements from diagnostic polysomnography via mathematical equations is possible but variable across populations.
AIMS: We aimed to (1) determine the optimal PAP requirement, (2) determine differences in optimal PAP requirements across OSA severity groups, (3) determine the relationship between optimal PAP requirement and diagnostic polysomnography measurements of OSA severity, and (4) develop a pilot equation to predict the optimal PAP requirement from diagnostic polysomnography in a sample from the Saudi population.
METHODS: We analyzed records pertaining to adult OSA patients (n = 215; 63% of males) who underwent standardized diagnostic and titration polysomnography in our sleep laboratory between 2015 and 2019. Demographic, anthropometric, and clinical information were also collected for the analysis. Inferential statistics were performed for comparisons between diagnostic and titration studies and between OSA severity groups. Regression analyses were also performed to determine the potential predictors of optimal PAP requirements. Data were presented as the mean (± standard deviation) or median (25th–75th quartiles) according to normality.
RESULTS: The median optimal PAP requirement was 13 (9–17) cmH2O. The optimal PAP requirement was significantly greater for male versus female participants (14 [10–17] vs. 12 [8–16] cmH2O) and for participants with severe OSA (16 [12–20] cmH2O, n = 119) versus those with moderate (11 [8–14] cmH2O, n = 63) or mild (9 [7–12] cmH2O, n = 33) OSA. When combined, nadir oxygen saturation, oxygen desaturation index, and arousal index could be used to predict the optimal PAP requirement (R2 = 0.39, F = 34.0, P < 0.001).
CONCLUSIONS: The optimal PAP requirement in the Saudi population is relatively high and directly correlated with OSA severity. Diagnostic polysomnography measurements of OSA severity predicted the optimal PAP requirement in this sample. Prospective validation is warranted. |
| first_indexed | 2024-04-10T09:57:31Z |
| format | Article |
| id | doaj.art-4aa3df2fb1ff4d939c4fd4e7e59da91c |
| institution | Directory Open Access Journal |
| issn | 1817-1737 1998-3557 |
| language | English |
| last_indexed | 2024-04-10T09:57:31Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Thoracic Medicine |
| spelling | doaj.art-4aa3df2fb1ff4d939c4fd4e7e59da91c2023-02-16T12:02:55ZengWolters Kluwer Medknow PublicationsAnnals of Thoracic Medicine1817-17371998-35572023-01-01181313810.4103/atm.atm_183_22Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi populationAhmad A BamagoosShahad A AlshaynawiAtheer S GariAtheer M BadawiMudhawi H AlhiniahAsma A AlshahraniRenad R RajabReem K BahajFaris AlhejailiSiraj O WaliCONTEXT: Positive airway pressure (PAP) is the first-line therapy for obstructive sleep apnea (OSA). Overnight PAP titration for determining optimal PAP requirements is expensive and often inconvenient. Prediction of optimal PAP requirements from diagnostic polysomnography via mathematical equations is possible but variable across populations. AIMS: We aimed to (1) determine the optimal PAP requirement, (2) determine differences in optimal PAP requirements across OSA severity groups, (3) determine the relationship between optimal PAP requirement and diagnostic polysomnography measurements of OSA severity, and (4) develop a pilot equation to predict the optimal PAP requirement from diagnostic polysomnography in a sample from the Saudi population. METHODS: We analyzed records pertaining to adult OSA patients (n = 215; 63% of males) who underwent standardized diagnostic and titration polysomnography in our sleep laboratory between 2015 and 2019. Demographic, anthropometric, and clinical information were also collected for the analysis. Inferential statistics were performed for comparisons between diagnostic and titration studies and between OSA severity groups. Regression analyses were also performed to determine the potential predictors of optimal PAP requirements. Data were presented as the mean (± standard deviation) or median (25th–75th quartiles) according to normality. RESULTS: The median optimal PAP requirement was 13 (9–17) cmH2O. The optimal PAP requirement was significantly greater for male versus female participants (14 [10–17] vs. 12 [8–16] cmH2O) and for participants with severe OSA (16 [12–20] cmH2O, n = 119) versus those with moderate (11 [8–14] cmH2O, n = 63) or mild (9 [7–12] cmH2O, n = 33) OSA. When combined, nadir oxygen saturation, oxygen desaturation index, and arousal index could be used to predict the optimal PAP requirement (R2 = 0.39, F = 34.0, P < 0.001). CONCLUSIONS: The optimal PAP requirement in the Saudi population is relatively high and directly correlated with OSA severity. Diagnostic polysomnography measurements of OSA severity predicted the optimal PAP requirement in this sample. Prospective validation is warranted.http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2023;volume=18;issue=1;spage=31;epage=38;aulast=Bamagoosautomatic positive airway pressure (apap)continuous positive airway pressure (cpap)effective pressuretherapeutic pressure |
| spellingShingle | Ahmad A Bamagoos Shahad A Alshaynawi Atheer S Gari Atheer M Badawi Mudhawi H Alhiniah Asma A Alshahrani Renad R Rajab Reem K Bahaj Faris Alhejaili Siraj O Wali Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population Annals of Thoracic Medicine automatic positive airway pressure (apap) continuous positive airway pressure (cpap) effective pressure therapeutic pressure |
| title | Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population |
| title_full | Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population |
| title_fullStr | Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population |
| title_full_unstemmed | Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population |
| title_short | Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population |
| title_sort | optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the saudi population |
| topic | automatic positive airway pressure (apap) continuous positive airway pressure (cpap) effective pressure therapeutic pressure |
| url | http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2023;volume=18;issue=1;spage=31;epage=38;aulast=Bamagoos |
| work_keys_str_mv | AT ahmadabamagoos optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT shahadaalshaynawi optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT atheersgari optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT atheermbadawi optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT mudhawihalhiniah optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT asmaaalshahrani optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT renadrrajab optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT reemkbahaj optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT farisalhejaili optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation AT sirajowali optimalpositiveairwaypressurerequirementandpolysomnographyindicesofobstructivesleepapneaseverityinthesaudipopulation |