Obstrüktif Uyku Apne Sendromlu Hastalarda Optimal Sürekli Pozitif Havayolu Basınç Düzeyini Etkileyen Faktörler

Öz Amaç: Bu çalışmada obstrüktif uyku apne sendromu (OUAS) olan hastalarda optimal CPAP düzeylerini etkileyen faktörlerin (VKİ, boyun çevresi, AHİ vb.) araştırılılması amaçlandı. Gereç ve Yöntem: Bu çalışmaya CPAP tedavisi için başarılı oto titrasyon uygulanan 120 OUAS hastası dahil edildi. Optimal CPAP seviyesi ile başlangıç verileri arasındaki korelasyonlar analiz edildi. Bulgular: 120 OUAS hastasında ortalama optimal basınç seviyesi 9.11 ± 2.81 cm H2O idi. Hafif, orta ve şiddetli OUAS gruplarında ortalama optimal basınç seviyeleri sırasıyla 8.01 ± 2.60, 8.32 ± 2.22 ve 9.71 ± 3.01 cm H2O idi. Apne / hipopne indeksi (AHI) (r = 0.297, p <0.001) ve minimal SaO2 (r = -0.264, p <0.004) optimal basınç seviyesi ile anlamlı korelasyon gösterdi. Titrasyon yetmezliği grubundaki 22 hastada genel olarak ağır AHI vardı; 6 hastada REM ilişkili, 2 hastada pozisyona bağlı OUAS mevcuttu. Titrasyon yetmezliği grubunda, belirli bir tanısı (hızlı göz hareketi (REM) veya pozisyon OUAS) bulunmayan hastalarda çok ciddi AHI düzeyleri vardı (ortalama AHI 67.90 idi). Sonuç: Korelasyon testlerine göre optimal CPAP seviyesinin en önemli iki belirleyicisi AHI ve en düşük saturasyon olarak bulundu.

Anahtar Kelimeler:

Obstrüktif uyku apne sendromu, Sürekli pozitif havayolu basıncı, apne, Polisomnografi

Factors Affecting Optimal Continuous Positive Airway Pressure Level in Patients with Obstructive Sleep Apnea Syndrome

Abstract Objectives: This study aimed to examine factors (BMI, neck circumference, AHI etc.) affecting optimal CPAP levels in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: A total of 120 patients with OSAS who underwent successful auto-titration for CPAP treatment were included in this study. Correlations between the optimal CPAP level and baseline data were analyzed. Results: The mean optimal pressure level in the 120 OSAS patients was 9.11 ± 2.81 cm H2O. The mean optimal pressure levels in the mild, moderate, and severe OSAS groups were 8.01 ± 2.60, 8.32 ± 2.22, and 9.71 ± 3.01 cm H2O, respectively. Apnea/hypopnea index (AHI) (r=0.297, p<0.001) and minimal SaO2 (r=-0.264, p<0.004) were significantly correlated with optimal pressure level. 22 patients in the titration failure group had severe AHI overall; 6 patients had REM-related and 2 had position-related OSAS. Patients in the titration failure group who did not have a specific diagnosis (rapid eye movement (REM) or positional OSAS) had very severe AHI levels (mean AHI of 67.90). Conclusion: According to the correlation tests, AHI and the lowest saturation were the two most important predictors of optimal CPAP level.

Keywords:

Obstructive sleep apnea syndrome, Continuous positive airway pressure, apnea, polysomnography,

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