BibTex RIS Kaynak Göster

“Objective and Subjective Responses to PAP Positive Airway Titration in Moderate and Severe Obstructive Sleep Apnea Syndrome”

Yıl 2009, Cilt: 1 Sayı: 2, 13 - 22, 01.08.2009

Öz

Aim: The purpose of this study was to compare the objective and subjective responses of moderate and severe OSAS patients to the fi rst night polysomnography and PAP titration test. Materials and methods: Ten female, 26 male a total 36 patients with a mean age of 54 ± 11 years range 32-73 and polysomnographically verifi ed as moderate and severe OSAS in Sleep Resarch Laboratory of Chest Diseases Department at Maltepe University Hospital between May 2008-May 2009 were included in the study. Subjective responses were obtained from the questionnaire applied on the morning after the fi rst polysomnography and PAP titration nights. Objective responses were also achieved from the polysomnography records of both test nights. We compared the objective and subjective responses of patients to both tests. Diff erences between the two tests nights were evaulated seperately. Visual analog scoring VAS was used to evaluate subjective values. Results: When we compared the responses to the fi rst night polysomnography and PAP titration we found statistically signifi cant diff erences betwen the values of total sleep time, REM sleep, respiratoy arousals, basal oxygen saturation and minimal avarage oxygen saturation. Subjective responses revealed that there were diff erences between the titration night and fi rst polysomnography night suggesting positive changes in terms of patient satisfaction and statistically signifi cant diff erences were achieved between the two nights regarding patient satisfaction of sleep quality and feeling of awaked rested in the morning p

Kaynakça

  • White DP. Sleep apnea. Proc Am Thorac Soc 2006;3.124–128.
  • Friedlander A.H, Walker L.A, Friedlander I.K. Diag- nosing and comanaging patients with obstructive sleep apnea syndrome. JADA 2000; 131: 1178-1184.
  • Mc Nicholas WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc 2008; 5:154- 160.
  • Piper A J, Sullivan CE. Eff ects of short- term NIPPV in the treatment of patients with severe obstructive sleep apnea and hypercapnia. Chest 1994;105:434-440.
  • Kushida CA, Chediak A, Berry RB, Brown LK, Gozal D, Iber C et al. Clinical guidelines for the manual titration of Positive Airway Pressue in patients with obstructive sleep apnea . Positive airway titration task force of the American Academy of Sleep Medicine. J Clin Sleep Med 2008; 4:157-171.
  • Morgenthaler TI, Aurora RN, Brown T, Zak R, Alessi C, Boehlecke B et al. Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: An update for 2007. An AASM Report .Sleep 2008;31:141-147.
  • Kakkar RK, Berry RB. Positive airway pressure treatment for obstructive sleep apnea. Chest 2007; 132:1057-1072.
  • Bousculet LT, Vargas MSM, Maldonado AC, Zuniga MR, Padilla RP.Autoadjusting positive pressure trial in adults with sleep apnea assessed by a simplified diag- nostic approach. J Clin Sleep Med 2008 ;4:341-347.
  • Mansfield D, Naughton MT. Obstructive sleep apnoea, congestive heart failure and cardiovascular disease. Heart Lung and Circulation 2005;14S:S2–S7.
  • Quan SF, Gersh BJ. Cardiovascular consequences of sleep-disordered breathing: Past, present and future. Circulation 2004; 109: 951-957.
  • Gould D.Visual Analog Score (VAS).J Clin Nursing 2001;10:697-706.
  • Rechtschaff en A, Kales A: A manual of stan- dardized terminology, techniques and scoring system for sleep satges in human subjects. Brain Information Service: Los Angeles, UCLA, 1968.
  • American Academy of Sleep Medicine. Sleep-re- lated breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research; The Report of an AASM Task Force. Sleep 1999;22:667-689.
  • Ballard RD, Gay PC, Strollo PJ. Interventions to improve compliance in sleep apnea patients previously non-compliant with continuous positive airway pressure. J Clin Sleep Med 2007;3:706-712.
  • Kushida CA, Littner MR, Hirshkowitz M, Morgen- thaler TI, Alessi CA, Bailey D et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep- related breathing disorders.An American Academy of Sleep Medicine Report.Practice parameters for CPAP and Bilevel PAP. Sleep 2006;29: 375-380.
  • Weaver TE, Mailsin G, Dinges DF, Bloxham T, George CFP, Greenberg H et al. Relationship between hours of CPAP use and achieving normal levels of sleepi- ness and daily functioning. Sleep 2007;30: 711-719.
  • Fidan F, Ünlü M, Sezer M, Geçici Ö, Kara Z. Uyku apne sendromlu hastalarda CPAP tedavisine uyum ve tedavinin anksiyete ve depresyon üzerine etkisi. Tüber- küloz ve Toraks Dergisi 2007; 55 (3):271-277.
  • Mulgrew AT, Cheema R, Fleetham J, Ryan F, Ayas NT. Eff icacy and patient satisfaction with autoadjusting CPAP with variable expiratory pressure vs standard CPAP: a two-night randomized crossover trial. Sleep Breath 2007;11:31-37.
  • Mc Nicholas WT. Compliance with nasal CPAP therapy with obstructive sleep apnoea:how much is enough? Eur Respir J 1997;10:969-970.
  • Schwartz DJ, Karatinos G. For Individuals with obstructive sleep apnea, Institution of CPAP therapy is associated with an amelioration of symptoms of depression which is sustained long term. J Clin Sleep Med 2007;3:631-635.

“Orta ve Ağır Obstrüktif Uyku Apne Sendromu OUAS Olgularında PAP Positive Airway Pressure Titrasyonuna Objektif ve Subjektif Yanıtın Değerlendirilmesi”

Yıl 2009, Cilt: 1 Sayı: 2, 13 - 22, 01.08.2009

Öz

Amaç: Bu çalışmada orta ve ağır obstrüktif uyku apne sendromu OUAS tanısı alıp PAP Positive Airway Pressure titrasyonuna alınan olguların, titrasyon gecesinde elde edilen objektif ve subjektif yanıtları ile ilk gece yapılan polisomnografi testi yanıtları karşılaştırılmıştır. Yöntem: Maltepe Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı Uyku Bozuklukları Laboratuvarında Mayıs 2008-Mayıs 2009 tarihleri arasında orta ve ağır OUAS tanısı almış olan erişkin, yaş ortalaması 54 ± 11 yıl 32-73 yaş arası , 10 kadın ve 26 erkek toplam 36 olgu çalışmaya alındı. Uyku laboratuvarında polisomnografi testine alınan tüm olgulara testin sonlandığı sabah uygulanan anket formundaki bilgiler kullanılarak, subjektif yanıtlar, polisomnografi kayıtlarındaki verilerden ise objektif yanıtlar elde edildi. İlk test gecesi, titrasyon gecesi ile objektif ve subjektif veriler kullanılarak karşılaştırıldı. Subjektif verilerin değerlendirilmesinde vizüel analog skorlama VAS yöntemi kullanıldı. Bulgular: İlk gece PSG sonuçları titrasyon gecesi sonuçları ile karşılaştırıldığında; toplam uyku süresi, REM periyodu, solunumsal arousallar, bazal oksijen satürasyonu ve en düşük oksijen satürasyonu değerlerinde; hastaların subjektif yanıtları değerlendirildiğinde ise, titrasyon gecesinde ilk gece yanıtlarına göre her zamanki uykusu ile karşılaştırıldığında uyku memnuniyeti algısında, dinlenmiş ve uykusunu almış olarak uyanma algısında olumlu yönde anlamlı farklılıklar elde edildi p

Kaynakça

  • White DP. Sleep apnea. Proc Am Thorac Soc 2006;3.124–128.
  • Friedlander A.H, Walker L.A, Friedlander I.K. Diag- nosing and comanaging patients with obstructive sleep apnea syndrome. JADA 2000; 131: 1178-1184.
  • Mc Nicholas WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc 2008; 5:154- 160.
  • Piper A J, Sullivan CE. Eff ects of short- term NIPPV in the treatment of patients with severe obstructive sleep apnea and hypercapnia. Chest 1994;105:434-440.
  • Kushida CA, Chediak A, Berry RB, Brown LK, Gozal D, Iber C et al. Clinical guidelines for the manual titration of Positive Airway Pressue in patients with obstructive sleep apnea . Positive airway titration task force of the American Academy of Sleep Medicine. J Clin Sleep Med 2008; 4:157-171.
  • Morgenthaler TI, Aurora RN, Brown T, Zak R, Alessi C, Boehlecke B et al. Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: An update for 2007. An AASM Report .Sleep 2008;31:141-147.
  • Kakkar RK, Berry RB. Positive airway pressure treatment for obstructive sleep apnea. Chest 2007; 132:1057-1072.
  • Bousculet LT, Vargas MSM, Maldonado AC, Zuniga MR, Padilla RP.Autoadjusting positive pressure trial in adults with sleep apnea assessed by a simplified diag- nostic approach. J Clin Sleep Med 2008 ;4:341-347.
  • Mansfield D, Naughton MT. Obstructive sleep apnoea, congestive heart failure and cardiovascular disease. Heart Lung and Circulation 2005;14S:S2–S7.
  • Quan SF, Gersh BJ. Cardiovascular consequences of sleep-disordered breathing: Past, present and future. Circulation 2004; 109: 951-957.
  • Gould D.Visual Analog Score (VAS).J Clin Nursing 2001;10:697-706.
  • Rechtschaff en A, Kales A: A manual of stan- dardized terminology, techniques and scoring system for sleep satges in human subjects. Brain Information Service: Los Angeles, UCLA, 1968.
  • American Academy of Sleep Medicine. Sleep-re- lated breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research; The Report of an AASM Task Force. Sleep 1999;22:667-689.
  • Ballard RD, Gay PC, Strollo PJ. Interventions to improve compliance in sleep apnea patients previously non-compliant with continuous positive airway pressure. J Clin Sleep Med 2007;3:706-712.
  • Kushida CA, Littner MR, Hirshkowitz M, Morgen- thaler TI, Alessi CA, Bailey D et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep- related breathing disorders.An American Academy of Sleep Medicine Report.Practice parameters for CPAP and Bilevel PAP. Sleep 2006;29: 375-380.
  • Weaver TE, Mailsin G, Dinges DF, Bloxham T, George CFP, Greenberg H et al. Relationship between hours of CPAP use and achieving normal levels of sleepi- ness and daily functioning. Sleep 2007;30: 711-719.
  • Fidan F, Ünlü M, Sezer M, Geçici Ö, Kara Z. Uyku apne sendromlu hastalarda CPAP tedavisine uyum ve tedavinin anksiyete ve depresyon üzerine etkisi. Tüber- küloz ve Toraks Dergisi 2007; 55 (3):271-277.
  • Mulgrew AT, Cheema R, Fleetham J, Ryan F, Ayas NT. Eff icacy and patient satisfaction with autoadjusting CPAP with variable expiratory pressure vs standard CPAP: a two-night randomized crossover trial. Sleep Breath 2007;11:31-37.
  • Mc Nicholas WT. Compliance with nasal CPAP therapy with obstructive sleep apnoea:how much is enough? Eur Respir J 1997;10:969-970.
  • Schwartz DJ, Karatinos G. For Individuals with obstructive sleep apnea, Institution of CPAP therapy is associated with an amelioration of symptoms of depression which is sustained long term. J Clin Sleep Med 2007;3:631-635.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Nesrin Sarıman Bu kişi benim

Ender Levent Bu kişi benim

Akın Cem Soylu Bu kişi benim

Şirin Yurtlu Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2009
Yayımlandığı Sayı Yıl 2009 Cilt: 1 Sayı: 2

Kaynak Göster

Vancouver Sarıman N, Levent E, Soylu AC, Yurtlu Ş. “Orta ve Ağır Obstrüktif Uyku Apne Sendromu OUAS Olgularında PAP Positive Airway Pressure Titrasyonuna Objektif ve Subjektif Yanıtın Değerlendirilmesi”. Maltepe tıp derg. 2009;1(2):13-22.