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PubMed2001

Sleep fragmentation: comparison of two definitions of short arousals during sleep in OSAS patients.

The measurement of arousals during sleep is useful to quantify sleep fragmentation. The criteria for electroencephalography (EEG) arousals defined by the American Sleep Disorders Association (ASDA) have recently been criticized because of lack of interobserver agreement. The authors have adopted a scoring method that associates the increase in chin electromyography (EMG) with the occurrence of an alpha-rhythm in all sleep stages (Université Catholique de Louvain (UCL) definition of arousals). The aim of the present study was to compare the two scoring definitions in terms of agreement and repeatability and the time taken for scoring in patients with obstructive sleep apnoea syndrome (OSAS) of varying severity. Two readers using both ASDA and UCL definitions scored twenty polysomnographies (PSGs) each on two occasions. The PSGs were chosen retrospectively to represent a wide range of arousal index (from 6-82) in OSAS patients. There was no difference in the arousal indices between readers and between scoring methods. The mean+/-SD difference between the two definitions (the bias) was 1.1+/-3.76 (95% confidence interval: -0.66-2.86). There was a strong linear relationship between the arousal index scored with the two definitions (r=0.981, p<0.001). Mean+/-SD scoring duration was significantly shorter for UCL than for ASDA definitions (18.5+/-5.4 versus 25.3+/-6.6 min, p<0.001). In conclusion, it has been found that in obstructive sleep apnoea syndrome patients, the American Sleep Disorders Association and Université Catholique de Louvain definitions were comparable in terms of agreement and repeatability.

Adult↗

PubMed2000

[Mini-invasive surgical approach for obstructive sleep apnea syndrome (OSAS). A case report].

It is well known that the obstructive sleep apnea syndrome (OSAS) is caused by the collapse of the pharyngeal walls and subsequent reduction in the diameter of all viscera. It is possible to increase the antero-posterior diameter by shifting the genioglosso muscle forward and suspending it; on the other hand the latero-lateral diameter can be achieved by sectioning the hyoid bone along the midline and through lateral fixation of the resulting stumps to the mandibula. This paper presents a clinical case of OSAS which underwent surgery using a procedure combining suspension of the genioglosso muscle and sectioning and suspension of the hyoid performed using a REPOSEa kit.

Humans↗

PubMed1998

[Clinical analysis of syndrome of obstructive sleep apnea (OSA) induced acute respiratory failure].

OBJECTIVE: To study the clinical characteristics of syndrome of OSA induced acute respiratory failure that might allow earlier recognition and treatment in critical care. METHOD: The clinical and laboratory characteristics of 9 patients were reviewed. RESULT: 9 patients (8 female, 1 male) presented with obesity and mental disturbance, with a BMI being 44.97 kg/m2, (45.25 kg/m2 in the female). The mean age of the group was 67.89 years (61-74 y). All had respiratory acidosis (mean pH 7.1732), hypercapnia (mean PaCO2 12.56 kPa) (8.53-19.09 kPa), and hypoxemia (mean PaO2 5.20 kPa) (3.87-5.87 kPa). During period of clinical stability all but 2 had awake hypercapnia (mean PaCO2 6.23 kPa) (5.10-7.29 kPa). Four of the 9 patients had pulmonary function test showing FEV1% > 70%. CONCLUSION: OSAS induced acute respiratroy failure has a sudden onset and various presentation and can be reversed with early and proper treatment. The severity of abnormal pulmonary function was less than what would be expected to cause respiratroy failure.

Acidosis, Respiratory↗

PubMed2001

[Nasal CPAP treatment and hypertension and altered cardiovascular variability associated with obstructive sleep apnea (OSA)].

In the past 5 years several epidemiologic studies have demonstrated that sleep-related breathing disorders are an independent risk factor for hypertension, probably resulting from a combination of repetitive episodes of hypoxia, hypercapnea, arousals, and a striking surge in sympathetic excitation, and altered baroreflex control during sleep. Obstructive sleep apnea (OSA) may lead to the cardiac arrhythmias and myocardial ischemia and it is a possible risk factor for stroke. We confirmed that nasal CPAP has been shown to lower blood pressure in some hypertensive OSA patients. Early recognition and treatment of sleep-apnea may improve cardiovascular function.

Baroreflex↗

PubMed2002

[Combined genioglossus advancement (ACMG): inferior sagittal mandibular osteotomy with genioglossus advancement and stabilization with suture in patients with OSAS. Preliminary clinical results].

Surgical treatment of obstructive sleep apnea syndrome (OSAS) centres on the identification of the level of obstruction of the upper airway and the choice of the most suitable procedure to correct it. Shaping of the retrolingual hypopharyngeal space is among the most difficult to achieve because it stems from an alteration of the soft tissue of the tongue, from the hypopharynx, and is correlated to the contraction pattern of the genioglossus and the pharyngeal constrictors. We propose a surgical technique of combined genioglossus advancement (CGA) in cases of anteroposterior collapse of the retrolingual airway. Four patients affected by OSAS (RDI average = 22 events/hour), evaluated as type III obstruction in the Fujita classification, presenting the indications for surgical management of retrolingual hypopharingeal obstruction, underwent treatment. They were studied by means of a guided medical history, fiberopy endoscopy evaluation and Muller maneuver, cephalometry, endocrine tests, pneumological examinations and polysomnography. The technique proposed consists in the advancement of the genioglossus muscle by means of a bone screw on the mandibular symphysis, according to the method described by Powell, associated with the stabilization of the base of the tongue with a suspension suture, following the technique originally described by the Author and DeRowe, but without using the Repose kit. This technique makes it possible to access the retrolingual site of obstruction more effectively, more economically and with no increase in morbidity when compared with the individual techniques. In all of the patients, the only complaints regarded dysaesthesia in the area of the lower lip innerved by the mental nerve for 2-5 weeks and moderate odynophagia for 2-3 weeks; there were no haemorrhages or infections. Deglutition of fluids and solids was resumed on the 3rd post-operative day. Polysomnography after 6 months documented three positive results and one partial result, on the basis of Sher's criteria. In conclusion, the CGA technique calls for advancement of the genioglossus insertion tubercle and stabilization of the tongue to be carried out at the same time, without using the Repose kit. The CGA technique is minimally invasive and does not involve cutaneous incisions, making it a therapeutic strategy which may be inserted in a multilevel protocol excluding transcutaneous access. It is therefore proposed for type III or type IIb cases in the Fujita classification.

Female↗

PubMed2003

[Central suspension operation of hyoid and lower jaw for OSAS].

OBJECTIVE: To evaluate the prospective effect and minimize the postoperative trauma of applying the central suspension operation of hyoid and lower jaw for the treatment for OSAS in 28 cases. METHOD: The data of 28 patients with obstructive sleep apnea syndrome(OSAS) operated with central suspension operation of hyoid and lower jaw and uvulopalatopharyngoplasty(UPPP) were analyzed. RESULT: One case (3.6%) reported unchanged snoring and apnea and hyponea index. Twenty-seven cases (96.4%) improved after the operation for at least 6 months to 3 years. The complications include tonsil bleeding (1 case), suffocation after extraction of endotracheal tube (1 case), temporal tongue insufficiency (1 case). CONCLUSION: On the previous basis of UPPP, we emphasize the protection of pharynx muscles and adjusting the position. The central suspension operation of hyoid and lower jaw not only increases the curative effect in the long run, but also avoids the tracheotomy.

Adult↗

PubMed2005

Obstructive Sleep Apnoea Syndrome (OSAS) and rhino-tubaric disfunction in children: therapeutic effects of RME therapy.

The aim of the study was to evaluate if RME (Rapid Maxillary Expansion) therapy could improve both the patency of the nasal airways and the Obstructive Sleep Apnoea Syndrome (OSAS). 42 children with a case history of oral breathing, snoring and night time apnoeas were studied. Selection criteria were: no adenotonsillar hypertrophy, Body Mass Index (BMI) below 24 and a malocclusion characterised by a narrow upper jaw, determined by postero-anterior cephalometric evaluation. Patients underwent an ENT visit with auditory and respiratory tests including daytime a sleepiness questionnaire, a 19-channel polysomnography, and an orthognatodontic examination; finally the patient underwent X-rays investigations. All the investigations were carried out before orthodontic therapy (T0), after one month (T1) with the device still on, and 4 months after the end of the orthodontic treatment which lasted for about 6-12 months (T2). All the changes induced by RME on the upper jaw and nasal septum were analysed by postero-anterior cephalometric evaluation in T0, T1 and T2. In all treated cases, the authors obtained an opening of the midpalatal suture; this was confirmed both by intraoral occlusal X-rays and postero-anterior cephalograms. The results reported by the 42 patients studied show that the R.M.E. therapy widens the nasal fossa and releases the septum thus restoring a normal nasal airflow with disappearance of obstructive sleep disordered breathing. Changing the anatomic structure, RME brought a significant functional improvement. Therefore the orthodontist can play an important role in the interdisciplinary treatment of OSAS patients.

Adolescent↗

PubMed1999

Arousal threshold to respiratory stimuli in OSA patients: evidence for a sleep-dependent temporal rhythm.

It has recently been described that the maximal respiratory effort developed at the end of an apnea (Pesmax)--which is regarded as an index of arousal threshold in patients with obstructive sleep apnea syndrome (OSA)--increases progressively during the night, probably as a consequence of associated sleep fragmentation. In order to find out whether the nocturnal trend of Pesmax may be more influenced by a sleep-dependent circadian rhythm than by sleep fragmentation, we revised the polygraphic recordings of 37 patients in whom obstructive apneas were recorded for at least 7 hours. In 15 of these patients, analysis was made for eight hours of the night. During each hour we analyzed at least 7 obstructive apneas, in which we measured the minimal esophageal pressure at the start of the apnea, the maximum value recorded at the end of the apnea (Pesmax), the difference from the minimum to the maximum (delta Pes), and the rate of increase in esophageal pressure (RPes). As indices of sleep fragmentation, we defined the number of arousals, awakenings and sleep state transitions. In the group of patients as a whole, we found a trend toward a gradual increase for apnea duration (F = 98.8, p < 0.001) and Pesmax F = 31.6, p < 0.001) which was significant from the first to the last hour. The time-dependent evolution of apnea duration and Pesmax showed that the rise in these two variables peaked during the first 3 hours of sleep, followed by a plateau and a decrease in the last hour of the night. This temporal profile was more evident when the analysis was available for 8 hours. No significant changes across the night were found for nocturnal hypoxemia and number of arousals. Considering the slope of Pesmax changes across the night, we saw that neither the apnea+hypopnea index nor the indices of sleep fragmentation affected the nocturnal trend. The present data demonstrate the presence of a nocturnal trend in arousal threshold in OSA patients independent of sleep fragmentation. The biphasic evolution of the arousal threshold may be caused by factors that influence the circadian and homeostatic processes.

Adult↗

PubMed2026

Treatment of OSA using mandibular advancement versus CPAP in improving cardiovascular health.

BACKGROUND: Obstructive sleep apnea is a significant risk factor for hypertension. We assessed the relative effectiveness of mandibular advancement device (MAD) versus continuous positive airway pressure (CPAP) in reducing 24 h ambulatory blood pressure (BP) and other health-related outcomes over 12 months. METHODS: In a randomized, non-inferiority trial, 321 participants with hypertension and increased cardiovascular risk were recruited for polysomnography. Of these, 220 with moderate-to-severe OSA (apnea-hypopnea index (AHI) ≥15 events/hour) were randomized to MAD or CPAP (1:1). We report the final outcomes at the 12-month follow-up. RESULTS: A total of 180 participants (MAD: 89; CPAP: 91) completed the 12-month follow-up. Median usage for MAD and CPAP was 5.5 and 4.9 h per night, respectively. Compared to baseline, the 24 h mean arterial BP at 12 months decreased by 2.3 mmHg (P = 0.200) in the MAD group and by 1.0 mmHg (P = 0.999) in the CPAP group. The difference between-groups was -0.6 mmHg (95% confidence interval: -2.53 to 1.39, non-inferiority P < 0.019). The MAD group demonstrated a larger reduction in asleep BP compared to the CPAP group. The prevalence of excessive daytime sleepiness in the MAD group decreased from 30.3% at baseline to 10.1% at 12-month follow-up (P = 0.001), and from 38.5% to 7.7% in the CPAP group (P < 0.001). The between-group difference was 10.6% (P = 0.097). No significant within-group or between-group differences were observed in the prevalence of arrhythmias and plasma levels of cardiac biomarkers. CONCLUSION: At 12-month, MAD is non-inferior to CPAP for reducing 24 h mean arterial BP in participants with hypertension and increased cardiovascular risk. TRIAL REGISTRATION: NCT04119999.

Humans↗

PubMed2003

OSAS in craniofacial syndromes: an unsolved problem.

Although the incidence of Obstructive Sleep Apnea syndrome (OSAS) in craniofacial syndromes is high, it is often not recognized and thus not treated. In order to study the diagnostics and treatment options for these patients, we studied a group of 72 patients treated in our hospital for Apert, Crouzon, or Pfeiffer syndrome, and compared our findings with the literature. There appears to be agreement on polysomnography (PSG) and airway endoscopy as the main diagnostic options, but therapies are very diverse. Early diagnostics and prompt therapy will prevent serious complications.

Adenoidectomy↗

PubMed2004

The validity of the OSA-18 among three groups of pediatric patients.

OBJECTIVE: To compare the signs and symptoms of obstructive sleep apnea syndrome in three groups of pediatric patients; solid organ transplant recipients, healthy children, and children with leukemia; in order to examine the effects of chronic illness on the obstructive sleep apnea-18-item questionnaire and to investigate its validity as a screening tool for obstructive sleep apnea in the pediatric solid organ transplant population. METHODS: In this cross-sectional study, there were two hundred and six subjects; 46 kidney transplant recipients, 59 liver transplant recipients, 34 patients with leukemia, and 67 healthy children. Adenotonsillar enlargement was assessed by using the obstructive sleep apnea-18-item questionnaire and by performing a focused physical examination of the oral and nasal cavity at the time of the child's routine visit in either the transplant clinic, outpatient oncology center, or general pediatric clinic. RESULTS: Comparison of questionnaire scores amongst the three groups showed significant differences between the healthy children and liver transplant recipients as well as those with leukemia. There was a significant difference in the physical examination scores of the children with leukemia as compared to the other groups. CONCLUSIONS: Adenotonsillar enlargement in pediatric transplant recipients can be an early indication of post-transplantation lymphoproliferative disorder. However, the prevalence of adenotonsillar enlargement in the transplant population does not appear to differ from that of the healthy population. Additionally, scores on the OSA-18 in the transplant population were confounded by chronic illness. Further prospective studies need to be performed to develop a screening tool to identify transplant recipients at risk for post-transplantation adenotonsillar lymphoma.

Adenoids↗

PubMed1996

Amplification of a rearranged form of the high-mobility group protein gene HMGIC in OsA-CI osteosarcoma cells.

Recently the high-mobility group protein gene HMGIC has been found to be rearranged in a variety of benign mesenchymal tumors with 12q13-q15 aberrations, such as angiomyxoma, fibroadenomas of the breast, lipomas, pleomorphic salivary gland adenomas, polyps of the endometrium, pulmonary chondroid hamartomas, and uterine leiomyomas. Here we report on HMGIC aberrations in the osteosarcoma cell line OsA-CI. In Northern blot studies, aberrant HMGIC transcripts were detected. Analysis of cDNA sequence data obtained after 3' rapid amplification of cDNA ends, indicated these to consist of 5' HMGIC sequences encoding the three DNA binding domains fused to ectopic sequences apparently derived from part of the human lumican (keratan sulphate proteoglycan) gene (LUM), which we mapped by fluorescence in situ hybridization (FISH) to chromosome 12q22-q23. Moreover, Southern blot analysis revealed amplification of this fusion gene but not of the 3'HMGIC sequences. This observation was independently confirmed by FISH analysis using yeast artificial chromosome (YAC) and cosmid clones, which furthermore indicated that the amplified 5'HMGIC sequences were contained within an amplicon of about 200 kb. Our results indicate that aberrations in HMGIC might not be restricted to benign mesenchymal tumors.

Blotting, Northern↗

PubMed1999

Does 2 years' nocturnal treatment with a mandibular advancement splint in adult patients with snoring and OSAS cause a change in the posture of the mandible?

The aim of this pilot study was to investigate the effects of 2 years' nocturnal treatment with a mandibular advancement splint in adult patients with snoring and obstructive sleep apnea syndrome with respect to possible development of a forward position of the mandible or other dentofacial changes. Thirty snoring and sleep apnea patients, mean age 55.3 years (SD, 8.61; range, 46.5 to 79.8 years), referred from the Ear, Nose, and Throat Department, were treated with an acrylic splint with full tooth coverage that advanced the mandible 5 to 8 mm (70% of maximal protrusion) and used 5 mm opening vertically. The splint was used 6 to 8 hours per night and 5 to 7 nights per week. Two lateral head radiographs were taken in centric occlusion, 1 before and 1 after 2 years of treatment. A small but statistically significant forward and downward change in mandibular position was found after treatment; mean was 0.4 mm (SD, 0.53; range, 0.0 to 2.0 mm; P <.001) and 0.3 mm (SD, 0.43; range, 0. 0 to 1.5 mm; P <.001), respectively. The forward and downward movement of the mandible was accomplished by a statistically significant increase in mandibular length-mean was 0.4 mm (SD, 0.62; range, 0.0 to 2.5 mm; P <.01)-and a significant decrease in overjet (P <.001) and overbite (P <.05). However, none of the patients reported any permanent sense of altered occlusion, and the anteroposterior distance between habitual occlusion (intercuspal position) and centric relation (retruded position) did not exceed 1. 0 mm in any of the patients either before or after the treatment. The change in mandibular position might be a result of a condylar and/or glenoid fossa remodeling or condylar position changes within the fossa as a compensatory reaction to the advancement of the mandible (bite jumping). However, to visualize and analyze such possible changes in detail, additional studies using lateral tomography of the temporomandibular joints or magnetic resonance imaging are required. Furthermore, because the treatment of snoring and OSAS patients is considered to be lifelong, long-term studies are needed to analyze if the small change in mandibular position will continue with further treatment.

Adaptation, Physiological↗

PubMed2000

Compliance with CPAP in elderly patients with OSA.

Background: Obstructive sleep apnea (OSA) is common in the general population and especially in the geriatric age group. Nasal continuous positive airway pressure (CPAP) is a highly effective treatment but can be difficult for some patients to use.Objective: We investigated the question if older patients were less compliant with CPAP therapy than younger patients and may not realize its benefits.Methods: We conducted a prospective, non-randomized study comparing use of CPAP in patients over age 65 with patients under age 65. One hundred and seven consecutive patients with a new diagnosis of obstructive sleep apnea were started on therapy with nasal CPAP. We obtained follow-up data on all 107 patients. Compliance with CPAP was assessed by patients subjective report of use and, in a subset of 21 patients, by objective measurement using a microchip installed in the CPAP unit that measures actual hours of use at therapeutic pressure.Results: The percentage of patients using CPAP regularly was not different in the two groups: 70% of patients in the over age 65 group used CPAP regularly vs. 72% of patients under age 65. The over 65 group used CPAP 6.5 nights per week, an average of 6.5 h of use per night. The under 65 group was not significantly different, using CPAP 6.8 nights per week, a mean of 6.7 h of use per night.Conclusion: Patients over age 65 are able to tolerate CPAP as well as patients under age 65.

Journal Article↗

PubMed2005

Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA).

AIM: The objective of this paper is to demonstrate that structural alterations of the nasal cavity, e.g. septal deviation and conchal hypertrophy have high incidence in patients with sleep apnea and hypopnea syndrome and must be addressed with associated specific procedures of the syndrome. TYPE OF STUDY: Clinical retrospective. CASUISTIC AND METHOD: A retrospective study of 200 patients was performed, with 196 male and 4 female, attended at the otorhinolaryngology ambulatory of Hospital Prof. Edmundo Vasconcelos and Unidade Paulista de Otorrinolaringologia, all of them subjected to polysomnography, otorhinolaryngological physical exam, endoscopy exam, and surgical treatment with nasal and pharyngeal procedures. RESULTS: All of them were subjected to pharyngeal procedure: uvulopalatopharyngoplasty or uvulopalatoplasty and nose procedure: 176 septoplasty with partial turbinectomy (88%) and 24 isolated turbinectomy, with satisfactory results. CONCLUSION: We can see that structural alterations of the nasal cavity have high incidence in patients with OSA.

Adult↗

PubMed2006

[Problems of hyomandibulopexia in patients with OSAS].

In cases of obstructive sleep apnea syndrome (OSAS) with intolerance of n-CPAP (nasal continuous positive airway pressure) treatment, hyoidthyroidpexia (synonym: hyoid suspension) has recently been advocated by some authors as a valuable surgical option. Despite a basically positive assessment, there is a risk of hindrance to the speaking and swallowing function. Moreover, the thyroid cartilage seems to be too weak for fixation of the hyoid with its complex muscular attachments. This reduces the likelihood of achieving positive long-term results. Considering aspects of preserving laryngeal function, we are reporting on 7 patients submitted to a hyomandibulopexia. This intervention counteracts the tendency of the tongue base to collapse by ventrolateral traction on the hypoglossal muscle via the severed greater horn of the hyoid. We have thus far had to correct our surgical procedure three times because of methodological problems in the postoperative phase. Specific problems with surgical materials like steel wire or Goretex are discussed. In conclusion, we explain why we consider a bone anchored Kevlar suture (FASTak of Arthrex) to be suitable for this operation. Considering functional aspects, our polysomnographic and phoniatric follow-up examinations point to a less traumatic surgical procedure with promising treatment results.

Bone Wires↗

PubMed1999

Changes in airway and hyoid position in response to mandibular protrusion in subjects with obstructive sleep apnoea (OSA).

This prospective clinical study examined the alterations in airway and hyoid position in response to mandibular advancement in subjects with mild and moderate obstructive sleep apnoea (OSA). Pairs of supine lateral skull radiographs were obtained for 13 female and 45 male, dentate Caucasians. In the first film, the teeth were in maximal intercuspation, while in the second the mandible was postured forwards into a position of maximum comfortable protrusion. Radiographs were traced and digitized, and the alterations in the pharyngeal airway and position of the hyoid were examined. Males and females were analysed separately. In males only, correlations were sought between the changes in hyoid and airway parameters, and the initial and differential radiographic measurements. In males, mean mandibular protrusion at the tip of the lower incisor was 5.3 mm, increasing its distance from the posterior pharyngeal wall by 6.9 mm (or 9 per cent). Movement of the hyoid showed extreme inter-subject variability, both in the amount and direction. In relation to the protruded lower jaw, the hyoid became closer to the gonion by 6.9 mm and to the mandibular plane by 4.3 mm. With respect to the upper face, a 1.3-mm upward and 1.1-mm forward repositioning was seen. The percentage alterations in airway dimensions matched or bettered the mandibular advancement. The minimum distances behind the soft palate and tongue improved by 1.0 and 0.8 mm, respectively. Despite their smaller faces, females frequently showed greater responses to mandibular protrusion than males. No cephalometric features could be identified which might indicate a favourable response of the airway to mandibular protrusion. Larger increments of hyoid movement were associated with an improved airway response, but the strength of the correlations was generally low.

Adult↗

PubMed1999

Long-term efficacy of fixed CPAP recommended by Autoset for OSAS.

The Autoset autotitration system (Resmed, Australia) was designed as an aid for determination of the effective level of CPAP. Two studies have shown that the 95% pressure centile during a night with Autoset, after excluding any periods with severe leak (P95), was well correlated with the pressure determined manually according to the reference method. However, the suitability of P95 under Autoset for treatment with conventional CPAP needed to be evaluated outside of the context of titration. The objective of this study was to measure the compliance and efficacy of CPAP at P95 determined by Autoset, after 3 months. Twenty-four patients who had undergone routine autotitration by Autoset under polysomnographic control in the laboratory for previously untreated OSAS were evaluated after 3 months of treatment with CPAP at P95. This evaluation was based on compliance, daily usage, determined by reading the hourly counter, Epworth sleepiness score and home respiratory recording under CPAP. Polysomnography under Autoset showed a significant reduction of abnormal respiratory events (apnea-hypopnea index (AHI): 5.7 (+/-4.6) vs 69.6 (+/-29.8) n/h; p<0.001). P95 was between 8.5 and 15 cm H2O (mean: 11.2 (+/-1.6)). Two patients were lost to follow-up. At 3 months, 18 out of 22 (82%) patients declared that they were still using their machine with a daily usage of 5.25 (+/-1.82) h. The Epworth sleepiness scale was significantly decreased (5 (+/-4.1) vs 11.4 (+/-5.4); p<0.05). P95 recommended by Autoset remained effective on abnormal respiratory events with a low AHI (4.1 (+/-3.2) n/h) and a low 4% oxygen desaturation index (3.6 (+/-4.5) n/h) under CPAP. This study confirms the efficacy of autotitration and the suitability of P95 determined by Autoset for long-term treatment by conventional CPAP at home.

Female↗