Search

Purpose: CPAP is the "gold standard" treatment for obstructive sleep apnea (OSA). Current CPAP models have developed additional functions including automatic CPAP and pressure relief. However, CPAP adherence has not improved over the last three decades. Many patients in low-income countries cannot afford these CPAP devices. A novel simple CPAP device with a fixed pressure without pressure controller was developed., Methods: Manual CPAP pressure titration was performed in 127 patients with OSA. Six patients with a titration pressure higher than 11 cmH 2 O and 14 patients who could not tolerate CPAP were excluded, leaving 107 participating in the following 2 studies. In study one, 54 of 107 patients were treated by both conventional fixed CPAP and simple CPAP in random order. In the second study, another 53 patients were treated by both autoCPAP in automatic function and simple CPAP in random order. Simple CPAP was fixed at 10 cmH 2 O, 8 cmH 2 O, and 6 cmH 2 O for patients whose titration pressure was between 9-10, 7-8, and ≤ 6 cmH 2 O, respectively. Conventional fixed CPAP device was set exactly the same as manual titration pressure., Results: All patients whose manual titration pressure ≤ 10 cmH 2 O were effectively treated by simple CPAP (AHI 40.7 ± 2.3 events/h before vs 2.5 ± 0.3 events/h after, p < 0.001). Patients expressed similar preferences for simple CPAP, autoCPAP, and conventional fixed CPAP (p > 0.05)., Conclusions: We conclude that a novel simple CPAP is an alternative treatment for most patients with OSA, which may widen access to CPAP therapy in the developing countries because of its low cost., (© 2023. The Author(s).)

Objective: To investigate the efficacy of simple device of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea (OSA). Methods: A double-blind study was performed on 53 OSA patients who received overnight simple CPAP and traditional CPAP in a random order during polysomnography. Pressure for CPAP treatment was manual titrated. The sleep apnea hypopnea index (AHI), arousal index (ArI), Oxygen desaturation Index (ODI), sleep structure and the preference for CPAP devices of the patients were observed. Results: AHI, ArI, ODI decreased significantly from 35.7 (18.1, 58.8)/h, (29.4±18.6)/h, 22.0 (13.9, 47.3)/h before treatment to 1.7 (0.7, 4.4)/h, (11.5±5.1) /h and 1.3 (0.4, 3.6)/h after treatment with simple CPAP, respectively (all P <0.05). There was no statistically significant difference in residual AHI [1.7 (0.7, 4.4)/h vs 1.9 (0.8, 4.3)/h], ArI [(11.5±5.1)/h vs (10.5±4.4)/h] and ODI [1.3 (0.4, 3.6)/h vs 1.3 (0.5, 4.2)/h] between treatment with simple CPAP and traditional CPAP (all P >0.05). The amount of time spent on deep sleep (stage Ⅲ) and rapid eye movement (REM) increased significantly from (6.2+ 6.6)% and (16.3+ 7.0)% before treatment to (11.7±8.5)% and (20.7±5.1)% during treatment with simple CPAP and (11.4±8.6)% and (20.9±5.0)% with traditional CPAP, respectively. The patients had no clear preference for two CPAP devices. Conclusion: Traditional CPAP can be replaced by the simple CPAP to treat patients with OSA.

Objective: To explore the prevalence of central sleep apnea in different age groups of children with sleep apnea-hypopnea (SAH)., Methods: A total of 431 children with SAH diagnosed by overnight polysomnography at our Sleep Center were retrospectively studied. They were divided into 3 groups based on their ages: toddler group (1 - < 3 years old), preschool group (3 - < 6 years old) and school group (6 - < 13 years old). The relationship between age and different types of apnea-hyponea index (AHI) was analyzed. And the prevalence of central sleep apnea and sleep structure were compared between the groups., Results: A negative correlation existed between age and central sleep apnea index (r = -0.322, P < 0.01). However, there was no correlation between age and obstructive apnea index (P > 0.05). AHI was similar in different age groups, but the medians of central sleep apnea index for toddler, preschool and school groups were 2.35, 1.50 and 0.90 events/h respectively (all P < 0.01). Sleep structure was similar between the groups (P > 0.05)., Conclusions: Central sleep apnea is common in children with sleep disordered breathing. The younger their ages, a higher prevalence of central sleep apnea.

Objective: To evaluate the variability of neural respiratory drive in patients with obstructive sleep apnea (OSA) and the effect of continuous positive airway pressure (CPAP) upon neural respiratory drive., Methods: We recorded diaphragm electromyogram (EMGdi) with multi-pair esophageal electrodes and its variability during wakefulness, sleep and treatment with CPAP in 13 patients with moderate to severe OSA diagnosed by an overnight full polysomnography (OSA group). Six normal subjects (control group) were also studied., Results: Coefficient of variation of EMGdi (CV-EMGdi) during wakefulness (15.4% +/- 3.8%) was similar to that during sleep (17.3% +/- 5.2, P > 0.05) in the control group. The CV-EMGdi during wakefulness, sleep, sleep apnea events and treatment with CPAP in OSA group was 14.7% +/- 1.9%, 40.7% +/- 12.0%, 29.1% +/- 7.5% and 15.4% +/- 4.6% respectively, CV-EMGdi during sleep or sleep apnea events was larger than that during wakefulness (P < 0.01). However, there was no difference in the CV-EMGdi during wakefulness and during treatment with CPAP (P > 0.05)., Conclusion: The variability of neural respiratory drive in patients with OSA is higher than that in normal subjects, and CPAP can reduce the variability of neural respiratory drive in patients with OSA.

Background: Pressure release continuous positive airway pressure (CPAP) is an evolution of CPAP that has been reported to improve patient comfort. We hypothesised the pressure release would lead to unloading of the inspiratory muscles and therefore conducted a prospective double-blind cross-over physiological study of autotitrating CPAP (APAP) against autotitrating pressure relief CPAP (PR-APAP)., Methods: Eleven patients with severe obstructive sleep apnoea (OSA; mean AHI 74.5+/-14.4/h) were studied. We assessed neural drive by recording the oesophageal pressure, gastric pressure, transdiaphragmatic pressure and the diaphragm EMG during overnight polysomnography., Results: Both APAP and PR-APAP significantly reduced neural respiratory drive. Transdiaphragmatic pressure swings during apnoea (30.2+/-11.5 cm H2O) before treatment decreased to 9.1+/-5.3 cm H2O for PR-APAP and 8.5+/-3.7 cm H2O for APAP. The transdiaphragmatic pressure and the diaphragm EMG did not differ significantly between APAP and PR-APAP. The gastric pressure swing at expiration phase disappeared during both APAP and PR-APAP when sleep respiratory events were eliminated., Conclusions: PR-APAP is not superior to APAP in terms of reducing neural respiratory drive. It is unnecessary to replace conventional APAP with PR-APAP for patients who have been successfully treated with traditional APAP.