Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
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Obstructive sleep apnea (OSA) is prevalent in the surgical population, and it has been suggested that preoperative patients should be screened and treated for OSA. However, it remains unclear whether patients diagnosed with OSA in the preoperative period adhere to prescribed CPAP therapy. ⋯ Adherence to prescribed CPAP therapy during the perioperative period was extremely low. African American race, male gender, and depressive symptoms were independently associated with reduced CPAP usage. Further research is needed to identify and overcome barriers to CPAP acceptance and adherence in the perioperative setting.
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Clinical Trial
Detection of sleep disordered breathing and its central/obstructive character using nasal cannula and finger pulse oximeter.
To assess the accuracy of novel algorithms using an oximeter-based finger plethysmographic signal in combination with a nasal cannula for the detection and differentiation of central and obstructive apneas. The validity of single pulse oximetry to detect respiratory disturbance events was also studied. ⋯ Automatic analysis based on routine pulse oximetry alone may be used to detect sleep disordered breathing with accuracy. In addition, the combination of photoplethysmographic signals with a nasal flow signal provides an accurate distinction between obstructive and central apneic events during sleep.
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Adaptive servoventilation (ASV) is often used to treat central sleep apnea (CSA) and complex sleep apnea syndrome (CompSAS). Both CompSAS and CSA may occur in the setting of CHF and with the use of chronic opioids. We hypothesized that ASV would be less successful in treatment of CSA and CompSAS secondary to opioid use than in CHF patients. ⋯ A commentary on this article appears in this issue on page 577.
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This case report including polysomnography shows reversal of central sleep apnea after opioid withdrawal. A patient using opioids for pain was diagnosed with central sleep apnea (CSA), but was not compliant with therapy. ⋯ Subsequent polysomnography showed no sleep disordered breathing. This is the first report of correction of CSA following opioid withdrawal confirmed by polysomnogram.