Polysomnography

About: Polysomnography is a research topic. Over the lifetime, 19527 publications have been published within this topic receiving 858718 citations. The topic is also known as: PSG & polysomnogram.

Long-term compliance with nasal continuous positive airway pressure (cpap)in obstructive sleep apnea patients and nonapneic snorers

Abstract: In a prospective study aimed at evaluating objectively the compliance with nasal continuous positive airway pressure (CPAP) treatment, 233 obstructive sleep apnea (OSA) (apnea index, > 10 apneas/hour) patients and 36 nonapneic snorers were studied. The compliance to treatment was measured by the mean rate of use of the CPAP device, obtained from a built-in time counter. The follow-up period was 874 +/- 48 in OSA patients and 675 +/- 83 in snorers. CPAP was proposed to all OSA patients but only to those snorers who felt improved after an initial laboratory night on CPAP. Nineteen OSA patients refused CPAP. Of the 214 OSA patients who accepted CPAP, 181 are still on treatment, with a mean daily rate of use of 5.6 +/- 0.1 hours (mean +/- SEM); 22 patients stopped CPAP after a variable period of time; 10 patients died and one acromegalic patient was considered cured after hypophysectomy for a pituitary adenoma. Depending upon the definition of acceptable compliance, the compliance rate in this group was between 77% and 89%. The mean rate of use was correlated with indices of disease severity (apnea index, apnea+hypopnea index, minimal SaO2 during sleep, daytime PaO2, pulmonary artery pressure). Thirty-six nonapneic snorers accepted CPAP. In this group, 26 are still on CPAP, with a mean daily rate of use of 5.4 +/- 0.5 hours; one patient died; one underwent uvolopalatopharyngoplasty without follow-up; and eight stopped CPAP. The compliance rate in this group was between 58% and 78%. This study shows that CPAP is reasonably accepted by OSA patients as well as by nonapneic snorers.(ABSTRACT TRUNCATED AT 250 WORDS)

Sleep during titration predicts continuous positive airway pressure compliance.

Abstract: STUDY OBJECTIVES Poor compliance with continuous positive airway pressure (CPAP) has been identified as a significant obstacle in the treatment of obstructive sleep apnea. While previous studies have focused on diagnostic screening variables, side effects, health beliefs, and measures of disease severity, investigators have generally ignored sleep parameters assessed during CPAP titration as predictors of compliance. As the titration night represents patients' initial exposure to nocturnal CPAP treatment, we hypothesized that nocturnal polysomnographic (PSG) variables, representing improved sleep at this time, would predict higher subsequent compliance. DESIGN Prospective analyses of a sequential case series were undertaken using nocturnal PSG variables during titration as early predictors of CPAP compliance. SETTING Accredited sleep center. PATIENTS Seventy-one patients with sleep apnea, aged 31-78 years, with a mean respiratory disturbance index of 62.0 +/- 32.2. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Compliance was calculated as mean hours per night of CPAP use over the initial follow-up period (mean 46.9 days). Standard PSG variables and subjective reports of sleep were used as predictive variables in multivariate analyses. Mean objective compliance was 5.04 hours per night +/- 2.59. Consistent with our hypothesis, the best predictor of compliance was change in sleep efficiency (SE) from diagnostic to titration night [F (1,66) = 17.31, p < .000 (r = .48)], indicating that patients whose sleep improved most on the titration night had the highest levels of compliance. This relationship was also significant after controlling for measures of disease severity obtained during the diagnostic testing night. Importantly, individuals whose sleep improved on the CPAP titration night had nightly compliance rates of approximately 2 hours greater than patients whose sleep did not improve during titration. CONCLUSIONS The findings suggest that patients' initial experience with CPAP treatment and, in particular, the degree of improvement in sleep during CPAP titration may be crucial factors in determining their subsequent use of this treatment modality.

Obstructive sleep apnea and the hyoid: a revised surgical procedure.

Abstract: Obstructive sleep apnea syndrome results from a loss of muscular activity of pharyngeal dilators and airway collapse at the hypopharynx-base of tongue or the oropharynx-soft palate. The hyoid arch and its muscle attachments strongly affect hypopharyngeal airway patency and resistance. On the basis of these concepts and previous experience, a modified hyoid suspension procedure is presented. Fifteen consecutively treated surgical patients underwent an isolated modified hyoid suspension procedure to correct hypopharyngeal obstruction. Oropharyngeal-palatal obstruction had previously been corrected or was thought not to be a component of the obstruction. Treatment outcomes were based on objective polysomnographic data and subjective clinical correction of excessive daytime sleepiness. The polysomnographic data included analysis of the respiratory disturbance index and lowest oxyhemoglobin desaturation. On the basis of these criteria, 12 of 15 patients (75%) had correction of their excessive daytime sleepiness and marked improvement in their sleep disorder breathing. The mean preoperative respiratory disturbance index was 44.7 +/- 22.6, and the lowest oxyhemoglobin desaturation was 82% +/- 6%. The postoperative respiratory disturbance index and lowest oxyhemoglobin desaturation were 12.8 +/- 6.9 and 86% +/- 5%, respectively. The modified hyoid suspension procedure appears to offer significant adjunctive treatment for hypopharyngeal obstruction in obstructive sleep apnea syndrome.