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Title of Journal: Sleep Breath

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Abbravation: Sleep and Breathing

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Springer-Verlag

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DOI

10.1002/pbc.22567

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1522-1709

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Continuous positive airway pressure intolerance as

Authors: Chie Nakazaki Akiko Noda Yoshinari Yasuda Seiichi Nakata Yasuo Koike Fumihiko Yasuma Toyoaki Murohara Tsutomu Nakashima
Publish Date: 2011/08/10
Volume: 16, Issue: 3, Pages: 747-752
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Abstract

Complex sleep apnea syndrome CompSAS is diagnosed after an elimination of obstructive events with continuous positive airway pressure CPAP when a central apnea index ≥5/h or Cheyne–Stokes respiration pattern emerges in patients with obstructive sleep apnea syndrome OSAS However the pathophysiology of CompSAS remains controversialOf the 281 patients with suspected OSAS all of whom underwent polysomnography conducted at Nagoya University Hospital we enrolled 52 patients with apnea–hypopnea index ≥15/h age 514 ± 133 years The polysomnographic findings left ventricular ejection fraction LVEF and nasal resistance were compared between the CompSAS patients and OSAS patientsFortythree patients were diagnosed with OSAS and nine patients with central sleep apnea syndrome by natural sleep PSG Furthermore 43 OSAS patients were classified into the OSAS patients OSAS group n = 38 and the CompSAS patients CompSAS group n = 5 by the night on CPAP PSG The nasal resistance was significantly higher in CompSAS group than in OSAS group 030 ± 010 vs 019 ± 007 Pa/cm3/s P = 0004 The arousal index percentage of stage 1 sleep and oxygen desaturation index were significantly decreased and the percentage of stage REM sleep was significantly increased in the OSAS group with the initial CPAP treatment but not in the CompSAS group In addition the patients with CompSAS showed normal LVEF

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