Effects of CPAP therapy withdrawal on exhaled breath pattern in obstructive sleep apnoea
<h4>Background</h4> <p>Obstructive sleep apnea (OSA) is highly prevalent and associated with cardiovascular and metabolic changes. OSA is usually diagnosed by polysomnography which is time-consuming and provides little information on the patient’s phenotype thus limiting a pers...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal article |
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BMJ Publishing Group
2015
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| Summary: | <h4>Background</h4> <p>Obstructive sleep apnea (OSA) is highly prevalent and associated with cardiovascular and metabolic changes. OSA is usually diagnosed by polysomnography which is time-consuming and provides little information on the patient’s phenotype thus limiting a personalized treatment approach. Exhaled breath contains information on metabolism which can be analyzed by mass spectrometry within minutes. The objective of this study was to identify a breath-profile in OSA recurrence by use of secondary-electrospray-ionization-mass spectrometry (SESI-MS).</p> <h4>Methods</h4> <p>Patients with OSA effectively treated with continuous positive airway pressure (CPAP) were randomized to either withdraw treatment (subtherapeutic CPAP) or continue therapeutic CPAP for two weeks. Exhaled breath analysis by untargeted SESI-MS was performed at baseline and two weeks after randomization. The primary outcome was the change in exhaled molecular breath pattern.</p> <h4>Results</h4> <p>30 patients with OSA were randomized and 26 completed the trial according to the protocol. CPAP withdrawal led to a recurrence of OSA (mean difference in change of oxygen desaturation index between groups +30.3/h; 95%CI:19.8/h,40.7/h, p<0.001) which was accompanied by a significant change in 62 exhaled features (16 metabolites identified). The panel of discriminating mass-spectral features allowed differentiation between treated and untreated OSA with a sensitivity of 92.9% and a specificity of 84.6%.</p> <h4>Conclusions</h4> <p>Exhaled breath analysis by SESI-MS allows rapid and accurate detection of OSA recurrence. The technique has the potential to characterize an individual’s metabolic response to OSA and thus makes a comprehensible phenotyping of OSA possible. </p> |
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