Source: Annual Congress 2009 - Socio-economic and epidemiological aspects of sleep apnoea
Disease area: Sleep and breathing disorders

Abstract

Introduction: last years CompSAS has been proposed as a prevalent disorder, occurring during CPAP titration in patients with predominantly obstructive sleep apnea hypopnea. Prevalence data differ between 2.5% and 15%. Some authors suggest that these central apneas are provoked due to application of inappropriately high CPAP pressures.
Aim: to evaluate the prevalence of CompSAS during routine manual CPAP titration, in a clinical sleep disorders centre.
Methods:
399 CPAP titration nights during polysomnography were retrospectively evaluated. 50 studies performed in patients with predominantly central sleep apnea hypopnea (AHI>20, CAI>OAI) were excluded from analysis. CompSAS was considered if during CPAP titration: OAI decreased, while CAI increased (≥5), with predominantly central apneas (>50% of AI). In our routine titration procedure CPAP pressure is only carefully elevated when central apneas occur.
Results:
262 CPAP titrations in predominantly OSA and 87 studies in patients with sleep hypopnea syndrome were evaluated (n=349). When this group was evaluated overall, only 9 patients demonstrated a CompSAS pattern (2.6%). Optimal pressure was determined at 7±1 mbar. Comparison between ‘normal‘ OSA and CompSAS did not show any significant difference concerning age, BMI, arterial blood gases, routine lung function pattern, severity of hypoxemia, AHI or alveolo-arterial oxygen gradient.
Conclusion:When CPAP therapy is started during manual CPAP titration, CompSAS is uncommon. It could be suggested that the low prevalence in our centre is at least partly due to our careful CPAP titration procedure, preventing high pressures.

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Citations should be made in the following way:
J. Verbraecken, L. Schoonis, B. Verplancke, A. Boudewyns, E. Hamans, P. Van de Heyning, W. De Backer (Edegem, Belgium). Prevalence of complex sleep apnea (CompSAS) during manual CPAP titration for obstructive sleep apnea. Eur Respir J 2009; 34: Suppl. 53, 3681

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