Abstract
Nasal continuous positive airway pressure (CPAP) is the treatment of choice in severe obstructive sleep-disordered breathing (SDB). Partial obstruction is usually considered as mild SDB with poor CPAP adherence. In a retrospective study, we investigated the occurrence of partial obstruction in 233 age and BMI-matched male–female pairs and its impact on CPAP adherence after one year using static-charge-sensitive bed. Women had less SDB compared with men (21.8 vs 31.7% of time in bed (TIB), p < 0.001), less periodic breathing (5.8 vs 15.6%, p < 0.001) but tended to have more partial obstruction (10.5 vs 7.5%, p = 0.174). In women, partial obstruction accounted for 50.2% of breathing abnormalities, in men 37.2% (p < 0.001). CPAP adherence was 60.5% in women and 56.9% in men. When taking into account the proportion of partial obstruction (≤5 vs >5% of TIB) or periodic breathing, there were no differences in women’s CPAP adherence (p = 0.130 and p = 0.148, respectively). Men with periodic breathing over 5% of TIB tended to be more adherent to CPAP, (p = 0.052). The high occurrence of partial obstruction in both genders and particularly in women suggests that the apnea–hypopnea index underestimates the occurrence of SDB. There are no concerns of low adherence when treating symptomatic partial obstruction during sleep. Partial obstruction may not represent mild SDB but a different entity.
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Acknowledgements
This work was supported by grants from Turku University Central Hospital (EVO grant), The Finnish Anti-Tuberculosis Association Foundation, Finnish Sleep Research Society, and The Väinö and Laina Kivi Foundation. Olli Polo was supported by The Tampere Tuberculosis Foundation.
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Anttalainen, U., Saaresranta, T., Kalleinen, N. et al. CPAP adherence and partial upper airway obstruction during sleep. Sleep Breath 11, 171–176 (2007). https://doi.org/10.1007/s11325-007-0102-5
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DOI: https://doi.org/10.1007/s11325-007-0102-5