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    Factors associated with treatment outcomes after use of auto-titrating CPAP therapy in adults with obstructive sleep apnea

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    Author
    Fashanu, Olabimpe S.
    Quan, Stuart F.
    Affiliation
    Asthma and Airways Research Center, University of Arizona College of Medicine
    Issue Date
    2022-03-14
    Keywords
    Auto-titrating positive airway pressure
    CPAP adherence
    CPAP efficacy
    Residual apnea hypopnea index
    Residual sleep apnea
    
    Metadata
    Show full item record
    Publisher
    Springer Science and Business Media LLC
    Citation
    Fashanu, O. S., & Quan, S. F. (2022). Factors associated with treatment outcomes after use of auto-titrating CPAP therapy in adults with obstructive sleep apnea. Sleep and Breathing.
    Journal
    Sleep and Breathing
    Rights
    © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Objectives To determine factors that are associated with OSA therapy outcomes with auto-titrating positive airway pressure (APAP). Methods We sequentially grouped patients from a retrospective cohort based on APAP efficacy (sufficiently vs. insufficiently treated; insufficiently treatment defined as residual AHI of ≥ 5), therapy adherence (adherent vs. non-adherent, non-adherence defined as < 70% usage for ≥ 4 h/night), and therapy outcomes (optimal vs. non-optimal and non-optimal outcomes defined as non-adherent and/or insufficiently treated). We subsequently compared each group. Results The insufficiently treated were older (68.4 ± 12.5 vs. 60.4 ± 13.1 years, p < 0.01) and had lower BMI (31.9 ± 6.3 vs. 37.9 ± 9.1 kg/m2, p < 0.01). They had higher baseline central apnea indices (CAI), longer leaks, higher peak pressures, and were less compliant. The non-adherent were younger (61.1 ± 12.6 vs. 65.5 ± 13.2 years, p = 0.03) and comprised more females (56.1 vs. 43.9%, p = 0.04). The leak duration per usage hour was higher in the non-compliant (median: 1.5; IQR 7.9 vs. median: 0.3; IQR 1.9 min/h; p < 0.01). The non-optimally treated had lower BMI, longer leaks, and less nightly usage. Multivariate analyses showed that leak duration was the common factor associated with treatment effectiveness and optimal therapy outcomes. Conclusions Various demographic and clinical factors were associated with treatment efficacy and adherence. However, leak duration was the common factor related to treatment efficacy and overall optimal therapy outcomes.
    Note
    12 month embargo; published: 14 March 2022
    ISSN
    1520-9512
    EISSN
    1522-1709
    DOI
    10.1007/s11325-022-02590-6
    Version
    Final accepted manuscript
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11325-022-02590-6
    Scopus Count
    Collections
    UA Faculty Publications

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