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Das erste oszilloresistometrisch gesteuerte auto-CPAP-Gerät (Somnosmart ®)—Eine Therapie des lageabhängigen Schlafapnoe-Syndroms?

The first auto-CPAP device controlled exclusively by forced oscillation technique (Somnosmart ®)—Treatment for position-dependent sleep apnea?

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Zusammenfassung

Mit dem Somnosmart ® steht ein neuartiges, ausschließlich oszilloresistometrisch gesteuertes auto-CPAP-Gerät zur Therapie des OSAS zur Verfügung. Diese Studie sollte die therapeutische Effektivität dieses neuen Systems untersuchen. 13 Patienten mit einem OSAS (mittlerer AHI 41,6/h) wurden im Anschluß an eine polysomnographische CPAP-Titration in einem randomisierten “cross-over”-Design sowohl mit einer konventionellen druckkonstanten CPAP-Therapie als auch mit dem Somnosmart ® behandelt. Analysiert wurden die polysomnographisch erhobenen Parameter und die Beurteilung der beiden Therapieformen durch die Patienten mittels standardisierter Fragebögen. Der mittlere AHI während der auto-CPAP-Therapie war mit dem AHI unter druckkonstanter CPAP-Therapie vergleichbar (3,31±3,33 vs. 3,95±2,84; n.s.). Weder eine Analyse der Schlafarchitektur noch der Arousal-Index (6,4±1,9 vs. 7,5±4,6; n.s.) zeigten signifikante Unterschiede. Auch die subjektive Einschlafneigung der Patienten war vergleichbar. Der mittlere Behandlungsdruck war jedoch unter der Somnosmart ®-Therapie signifikant niedriger als unter der konventionellen Therapie (7,52±2,32 vs. 8,84±1,46; p=0,028). Insbesondere der in Seitenlage applizierte Mitteldruck war bemerkenswert niedriger als der Mitteldruck in Rückenlage (6,60±2,85 vs. 8,03±2,21; p=0,019). Zusammenfassend zeigte sich das auto-CPAP-Gerät ebenso effektiv wie die konventionelle CPAP-Therapie, der mittlere Behandlungsdruck, besonders in Seitenlage, war jedoch signifikant niedriger.

Summary

Recently a novel auto-CPAP device based on the forced oscillation technique has become available (Somnosmart ®, Weinmann). The present study was designed to evaluate the therapeutic efficacy and the treatment pressure of this novel auto-CPAP machine. Following CPAP titration, 13 patients with OSA (mean AHI 41.6/h) were allocated to conventional CPAP and auto-CPAP treatment under polysomnographic control in randomised order. The patients were asked to asses each treatment and their subjective daytime sleepiness using questionnaires. The mean apnoea/hypopnoea index (AHI) during auto-CPAP treatment was comparable with that during conventional CPAP treatment (3.31±3.33 vs. 3.95±2.84). Neither an analysis of sleep architecture nor the arousal index (6.4±1.9 vs. 7.5±4.6) revealed any significant differences. The mean pressure during auto-CPAP treatment, however, was significantly lower than that employed in conventional CPAP treatment

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Literatur

  1. American Thoracic Society, Indications and standards for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes. Am J Respir Crit Care Med 150: 1738–1745, 1994.

    Google Scholar 

  2. Badia JR, Farre R, Montserrat JM, Ballester E, Hernandez L, Rotger M, Rodriguez RR, Navajas D: Forced oscillation technique for the evaluation of severe sleep apnoea/hypopnoea syndrome: a pilot study. Eur Respir J 11: 1128–1134, 1998.

    Article  CAS  PubMed  Google Scholar 

  3. Ficker JH, Wiest GH, Fuchs FS, Lehnert G, Hahn EG: Typische Artefakte beim Einsatz der Oszilloresistometrie während einer n-CPAP-Therapie. Somnologie 3 (Suppl 1): 8, 1999.

    Google Scholar 

  4. Ficker JH, Wiest GH, Lehnert G, Fuchs FS, Rühle KH, Hein H, Hahn EG: Feasibility of a self-setting CPAP-device based on measurement of upper airway impedance Z by forced oscillation technique. Am J Respir Crit Care Med 157: A343-1998.

    Google Scholar 

  5. Ficker JH, Wiest GH, Lehnert G, Wiest B, Hahn EG: Evaluation of an auto-CPAP device for treatment of obstructive sleep apnoea. Thorax 53: 648–652, 1998.

    Article  Google Scholar 

  6. Grunstein RR: Sleep-related breathing disorders. 5. Nasal continuous positive airway pressure treatment for obstructive sleep apnoea. Thorax 50: 1106–1113, 1995.

    Article  CAS  PubMed  Google Scholar 

  7. Harding FM, Pitson DJ, Stradling JR: Use of the Epworth Sleepiness Scale to demonstrate response to treatment with nasal continuous positive airways pressure in patients with obstructive sleep apnoca. Respiratory Medicine 89: 617–620, 1995.

    Article  Google Scholar 

  8. Hein H, Müllauer B, Magnussen H: Ausmass der Schwankungen des minimal notwendigen CPAP-Druckes in einer Nacht. Pneumologie 51: 786–788, 1997.

    PubMed  Google Scholar 

  9. Meurice JC, Marc I, Series F: Efficacy of auto-CPAP in the treatment of obstructive sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 153: 794–798, 1996.

    CAS  PubMed  Google Scholar 

  10. Meyer TJ, Eveloff SE, Kline LR, Millman RP: One negative polysomnogram does not exclude obstructive sleep apnea. Chest 103: 756–760, 1993.

    CAS  PubMed  Google Scholar 

  11. Miljeteig H, Hoffstein V: Determinants of continuous positive airway pressure level for treatment of obstructive sleep apnea. Am Rev Respir Dis 147: 1526–1530, 1993.

    CAS  PubMed  Google Scholar 

  12. Penzel T, Hajak G, Hoffmann RM, Lund L, Podszus T, Pollmächer T, Schäfer T, Schulz H, Sonnenschein W, Spieweg I: Empfehlungen zur Durchführung und Auswertung polygraphischer Ableitungen im diagnostischen Schlaflabor. EEG-EMG 24(2): 65–70, 1993.

    Google Scholar 

  13. Pevernagie DA, Shepard JW: Relations between sleep stage, posture and effective nasal CPAP levels in OSA. Sleep 15: 162–167, 1992.

    CAS  PubMed  Google Scholar 

  14. Rühle KH, Schlenker E, Randerath W: Upper Airway Resistance Syndrome. Respiration 64: 29–34, 1997.

    PubMed  Google Scholar 

  15. Series F, Marc I: Efficacy of automatic continuous positive airway pressure therapy that uses an estimated required pressure in the treatment of the obstructive sleep apnea syndrome. Ann Intern. Med 127: 588–595, 1997.

    CAS  PubMed  Google Scholar 

  16. Series F, Marc I, Cormier Y, La Forge J: Required levels of nasal continuous positive airway pressure during treatment of obstructive sleep apnoea. Eur Respir J 7: 1776–1781, 1994.

    Article  CAS  PubMed  Google Scholar 

  17. Sforza E, Krieger J, Bacon W, Petiau C, Zamagni M, Boudewijns A: Determinants of effective continuous positive airway pressure in obstructive sleep apnea. Role of respiratory effort. Am J Respir Crit Care Med 151: 1852–1856, 1995.

    CAS  PubMed  Google Scholar 

  18. Sullivan CE, Issa FG, Berthon Jones M, Eves L: Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet 1: 862–865, 1981.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Abteilung Pneumologie, Medizinische Klinik I mit Poliklinik, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Deutschland

    J. H. Ficker, F. S. Fuchs, G. H. Wiest, G. Asshoff, G. Lehnert & E. G. Hahn

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  1. J. H. Ficker
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  2. F. S. Fuchs
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  3. G. H. Wiest
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  4. G. Asshoff
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  5. G. Lehnert
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  6. E. G. Hahn
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Correspondence to J. H. Ficker.

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Ficker, J.H., Fuchs, F.S., Wiest, G.H. et al. Das erste oszilloresistometrisch gesteuerte auto-CPAP-Gerät (Somnosmart ®)—Eine Therapie des lageabhängigen Schlafapnoe-Syndroms?. Somnologie 3, 328–334 (1999). https://doi.org/10.1007/s11818-999-0044-1

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