Sleep Disorders |

Correlation Between Upright and Supine Respiratory Resistance and Apnea-Hypopnea Index FREE TO VIEW

Robert Walter; Michael Perkins; Jacob Collen; Ray Irvine; Andrea Pham; Daniel Ephrem; Angela Dietsch, PhD; Nancy Pearl-Solomon; Arthur Johnson, PhD; Jafar Vossoughi, PhD; Aaron Holley
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Walter Reed National Military Medical Center, Bethesda, MD

Chest. 2014;146(4_MeetingAbstracts):960A. doi:10.1378/chest.1991303
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SESSION TITLE: Diagnosis of Sleep Apnea

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 27, 2014 at 07:30 AM - 08:30 AM

PURPOSE: Due to increasing demand, many sleep centers experience prolonged wait times before patients can be evaluated for obstructive sleep apnea (OSA) using polysomnography (PSG). Establishing an accurate means of screening in the office is essential for prioritizing studies. We sought to determine whether measurements of respiratory resistance at the initial office visit could predict the presence and severity of sleep apnea.

METHODS: The airflow perturbation device (APD) is a handheld unit that provides measurements for both inspiratory and expiratory resistance. Along with baseline demographic factors, we measured inspiratory and expiratory resistance in both the upright and supine positions prior to PSG. Resistance values were correlated with the apnea-hypopnea index (AHI) on PSG.

RESULTS: We enrolled 50 patients within our study. Mean age, BMI, and AHI were 40.8±9.1, 28.9±4.2, and 14.8±12.4, respectively. At baseline, the average inspiratory resistance was 3.2±0.5 cmH20/L/s in the sitting position and 3.8±0.8 cmH20/L/s in the supine position. The corresponding values for expiratory resistance were 3.5±0.8 cmH20/L/s and 4.3±1.2 cmH20/L/s. BMI (r=0.30, p=0.04), age (r=0.30, p=0.04), and change in expiratory resistance going from sitting to supine (r=0.30, p=0.05) were all associated with AHI. Logistic regression analysis demonstrated that BMI (OR: 1.5, 95% CI: 1.0-2.2; p=0.047), age (OR 1.4, 95% CI: 1.1-1.9; p=0.01), and expiratory resistance going from sitting to supine (OR 7.7, 95% CI: 1.1-54.9; p=0.04) were all independently associated with an AHI ≥ 5 on PSG.

CONCLUSIONS: Resistance values measured in the office using a hand-held device were independently associated with AHI and the presence of OSA.

CLINICAL IMPLICATIONS: Along with known predictors of OSA, the APD can be used in the office to help clinicians predict which patients will need PSG.

DISCLOSURE: Arthur Johnson: Other: Patent Holder Airway Perturbation Device Jafar Vossoughi: Other: Patent Holder Airway Perturbation Device The following authors have nothing to disclose: Robert Walter, Michael Perkins, Jacob Collen, Ray Irvine, Andrea Pham, Daniel Ephrem, Angela Dietsch, Nancy Pearl-Solomon, Aaron Holley

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