Citation Information :
Radhakrishnan A, Sreedharan SE, Agrawal P, Anees CA, Pradeep M, Sharma PS. Diabetics with Obstructive Sleep Apnea need Higher Positive Airway Pressures. Indian Sleep Med 2017; 12 (3):39-43.
Introduction: Continuous positive airway pressure (CPAP) is the only proven therapy for moderate to severe obstructive sleep apnea syndrome (OSAS). The CPAP requirements can widely vary among individuals. We studied the demographic, clinical, and polysomnographic (PSG) predictors of high CPAP requirement (pressures >10 cm H2O) in a cohort of patients with OSAS.
Materials and methods: Consecutive patients with PSG-proven moderate to severe OSAS attending the Sleep Clinic, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India, were prospectively recruited for the study from November 2014 till October 2015. After informed consent, demographic data, risk factor profile, and PSG data were extracted using a structured pro forma. All the patients underwent overnight CPAP titration in the sleep laboratory as per guidelines. The patients were grouped into two, those requiring CPAP ≤ 10 and >10 cm H2O. Pearson correlation and chi square tests were used to study the association between variables.
Results: A total of 64 patients (55 male, 9 female) with OSAS underwent CPAP titration during the study period. Mean age of the study group was 53.81 ± 12.01 (26–85 years) and majority were overweight by Asian standards [mean body mass index (BMI) 29.31 ± 5.01]. Mean apnea-hypopnea index (AHI) of the cohort was 62.28. Average CPAP requirement was 11.82 cm H2O. We found that neck circumference, presence of diabetes mellitus (DM), and AHI severity were independent predictors for higher PAP requirements, while gender, BMI, and other vascular risk factors were not predictive of high PAP requirements.
Conclusion: Diabetes mellitus and neck circumference are better predictors of higher CPAP requirements in Indian population than BMI. Those with higher AHI required more pressures while apnea duration failed to show an association with higher PAP.
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