Factors associated with residual apnea-hypopnea index variability during continuous positive airway pressure treatment

Chest. 2023 Jan 12:S0012-3692(23)00040-5. doi: 10.1016/j.chest.2022.12.048. Online ahead of print.ABSTRACTBACKGROUND: Continuous positive airway pressure (CPAP) is the first-line therapy for obstructive sleep apnea (OSA). A high or variable residual apnea-hypopnea index (rAHI) reflects treatment failure and is potentially triggered by exacerbation of cardiovascular comorbidities. Previous studies showed that high rAHI and large rAHI variability are associated with underlying comorbidities, OSA characteristics at diagnosis, and CPAP equipment including mask type and settings.RESEARCH QUESTION: What are the factors associated with predefined groups with low to high rAHI variability?STUDY DESIGN AND METHODS: Registry-based study, including patients diagnosed with OSA and under CPAP treatment with at least 90 days of CPAP remote monitoring. We applied the Hidden Markov Model to analyze the day-to-day trajectories of rAHI variability using telemonitoring data. An ordinal logistic regression analysis identified factors associated with a risk of having a higher and more variable rAHI under CPAP treatment.RESULTS: The 1,126 included patients were middle-aged (median (Q1; Q3) age: 66 (57; 73) years), predominantly male (n=791, 70.3%) and obese (median (Q1; Q3) body mass index: 30.6 (26.8; 35.2) kg/m2). Three distinct groups of rAHI trajectories were identified using Hidden Markov Model: low rAHI variability group (Low-Var group, N=393 [35%]), moderate rAHI variability group (Mod-Var g...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research