Comorbidity modulates non invasive ventilation-induced changes in breath print of obstructive sleep apnea syndrome patients
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In obstructive sleep apnea syndrome (OSAS), exhaled volatile organic compounds (VOCs) change after long-term continuous positive airway pressure (CPAP). The objective of the study was to verify whether changes in VOCs pattern are detectable after the first night of CPAP and to identify correlates, if any, of these changes.
Fifty OSAS patients underwent a multidimensional assessment and breath print (BP) analysis through 28 sensors e-nose at baseline and after the first night of CPAP. Boxplots of individual BP evolution after CPAP and groups were compared by ANOVA and Fisher’s exact t. Partial least square discriminant analysis (PLS-DA), with leave-one-out as cross-validation was used to calculate to which extent basal BP could predicts changes in apnea-hypopnea index (AHI).
CPAP was effective in all the patients (delta AHI 35.8 events/h; residual AHI 6.0 events/h). BP dramatically changed after a single-night CPAP and changes conformed to two well-distinguished patterns: pattern C (n = 29), characterized by consonant boxplots, and pattern D (n = 21), with variably discordant boxplots. The average number of comorbid diseases (1.55 [standard deviation, SD 1.0] in group C, 3.14 [SD 1.8] in group D, p < 0.001) and the prevalence of selected comorbidity (diabetes mellitus, metabolic syndrome, and chronic heart failure), were the only features distinguishing groups.
We found that BP change after a single night of CPAP largely depends upon comorbidity. Comorbidity likely contributes to phenotypic variability in OSAS population. BP might qualify as a surrogate index of the response to and, later, compliance with CPAP.
KeywordsObstructive sleep apnea Continuous positive airway pressure Electronic nose Breath fingerprint Diagnosis Compliance to therapy
Conflict of interest
Author’s contribution and acknowledgement
Raffaele Antonelli Incalzi: study concept and design, analysis and interpretation of data, preparation of manuscript, revision of the manuscript for important intellectual content.
Giorgio Pennazza: acquisition of subjects and data, study concept and design, analysis and interpretation of data, statistical advice, preparation of manuscript
Simone Scarlata: acquisition of subjects and data, study concept and design, analysis and interpretation of data, preparation of manuscript.
Marco Santonico: acquisition of subjects and data, study concept and design, analysis and interpretation of data, preparation of manuscript.
Chiara Vernile: acquisition of subjects and data; analysis and interpretation of data;
Livio Cortese: acquisition of subjects and data.
Elena Frezzotti: acquisition of subjects and data.
Claudio Pedone: analysis and interpretation of data, statistical advice, preparation of manuscript.
Arnaldo D’Amico: analysis and interpretation of data, revision of the manuscript for important intellectual content
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