Sleep & breathing = Schlaf & Atmung
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Randomized Controlled Trial Comparative Study
A new predictive model for continuous positive airway pressure in the treatment of obstructive sleep apnea.
Numerous mathematical formulas have been developed to determine continuous positive airway pressure (CPAP) without an in-laboratory titration study. Recent studies have shown that style of CPAP mask can affect the optimal pressure requirement. However, none of the current models take mask style into account. Therefore, the goal of this study was to develop new predictive models of CPAP that take into account the style of mask interface. ⋯ Our data show that predictive models of CPAP that take into account mask style can significantly improve the formula's accuracy. Most of the past models likely focused on model development with nasal masks (mask style used for model development was not typically reported in previous investigations) and are not well suited for patients using an oronasal interface. Our new oronasal CPAP prediction equation produced significantly improved performance compared to the well-known Miljeteig and Hoffstein formula in patients titrated on CPAP with an oronasal mask and was also significantly related to laboratory determined optimal CPAP.
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Comparative Study
Positional therapy in patients with residual positional obstructive sleep apnea after upper airway surgery.
A considerable portion of patients has residual positional obstructive sleep apnea (POSA) after upper airway surgery. Those patients could benefit from additional treatment with positional therapy (PT). The objective of this prospective study was to assess the additional effect of PT in patients with residual POSA after upper airway surgery for sleep apnea. ⋯ The results of this study indicate that additional PT in a complex OSA patient population with residual POSA after surgery can increase overall therapeutic effectiveness by improving the median MDA from 39.5 % (effect of surgery alone) to 65.6 % (effect of combining surgery and PT).
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The purpose of this study was to evaluate the relationship between daytime activity (sedentary time, moderate- to vigorous-intensity physical activity [MVPA]) and indices of polysomnographically (PSG) assessed sleep, including sleep-disordered breathing (SDB). ⋯ Sedentary time and MVPA were associated with SDB. Whether reducing sedentary time leads to lower SDB severity deserves future exploration.
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Randomized Controlled Trial
CPAP therapy for patients with sleep apnea and type 2 diabetes mellitus improves control of blood pressure.
Obstructive sleep apnea (OSA) is highly associated with type 2 diabetes mellitus (DM), and treatment of OSA may have a positive impact on cardiometabolic profile. This study investigates the effects of continuous positive airway pressure (CPAP) treatment on glycemic control and cardiometabolic parameters in patients with diabetes. ⋯ In patients with type 2 DM and moderate to severe OSA, 3 months of CPAP therapy did not decrease HbA1c but lowered systolic and diastolic blood pressures. In view of a potentially limited effect size of CPAP treatment on glycemic control, sample size estimation for future randomized controlled studies must make adequate allowance for influence from external factors of medications/diet and CPAP use.
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Meta Analysis Comparative Study
Meta-analysis of all-cause and cardiovascular mortality in obstructive sleep apnea with or without continuous positive airway pressure treatment.
The associations between obstructive sleep apnea (OSA) and all-cause and cardiovascular mortality are well established but are not entirely consistent. To accurately evaluate these associations as well as the therapeutic effects of continuous positive airway pressure (CPAP), we conducted a comprehensive meta-analysis of all eligible cohort studies. ⋯ Greater attention should be paid to severe OSA, as it is an independent predictor for risk for all-cause and cardiovascular mortality. CPAP is an effective treatment that reduces risk of mortality.