Is it important to know the predominant
respiratory event in AHI for the management of
patients with OSA?

Bulut, Barış; Ayöz, Sümeyye; GULBAY, BANU; Acıcan, Turan

doi:10.5578/tt.20229809

Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?

Banu GÜLBAY, (Ankara Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Barış BULUT, (Ankara Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Sümeyye AYÖZ, (Ankara Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Turan ACICAN (Ankara Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara, Türkiye)

Tüberküloz ve Toraks

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Yıl: 2022 Cilt: 70 Sayı: 2 Sayfa Aralığı: 187 - 196 Metin Dili: İngilizce DOI: 10.5578/tt.20229809 İndeks Tarihi: 06-07-2022

Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?

Öz:

Introduction: Obstructive sleep apnea (OSA) is a heterogeneous disorder. The apnea-hypopnea index (AHI) cannot fully reflect this heterogeneity on its own. In this study, the OSA patients were analyzed by grouping them based on the predominant type of respiratory event, and the distinctive findings of each group were evaluated. Materials and Methods: The records of 213 patients with OSA were evaluated retrospectively and the patients were divided into three groups as Group 1 (apnea-predominant OSA; apnea index (AI)≥ 2x hypopnea index (HI) and HI≤ 15/hour), Group 2 (hypopnea-predominant OSA; HI≥ 2xAI and AI≤ 15/ hour), and Group 3 [No Respiratory Event-Predominant OSA (NREP OSA)]. Results: There were 65 patients in Group 1, 58 patients in Group 2, and 90 patients in Group 3. There was no difference between the groups in terms of sex, age, body-mass index, the distribution of symptoms, and concomitant diseases (p> 0.05). Only witnessed apnea was more frequently described by Group 1 patients (p= 0.042). Except for the higher N2 percentage and arousal index (p= 0.009, p= 0.011, respectively) in those with apnea-predominant OSA compared to those with hypopnea-predominant OSA, there was no difference in sleep architecture. In the apnea-predominant group, while the AHI, apnea durations (p= 0.000, 0.000, 0.000, respectively), total oxygen desaturation index (tODI), NREM ODI and REM ODI were higher (p= 0.000, 0.000, 0.047, respectively), nocturnal minimum oxygen saturation (SpO2) was lower (p= 0.001). Conclusion: This study concluded that apnea-predominant OSA patients had more severe OSA in terms of AHI, respiratory event durations, and problems in oxygenation. These differences may guide the management of OSA.

Anahtar Kelime:

OSA’lı hastaların yönetiminde AHİ’deki baskın solunumsal olayın bilinmesi önemli midir?

Öz:

Giriş: Obstrüktif uyku apne (OSA) heterojen bir hastalıktır. Apne-hipopne indeksi (AHİ) tek başına, bu heterojeniteyi tam olarak yansıtamamaktadır. Çalışmamızda; OSA’lı hastalar polisomnografide baskın olan solunumsal olayın tipine göre gruplandırılarak analiz edildi ve her bir grubun karakteristik bulguları değerlendirildi. Materyal ve Metod: OSA tanısı (total AHI≥ 15/sa) konulmuş 213 hastanın dosyası retrospektif olarak klinik ve polisomnografik verileri açısından incelendi. OSA’lı hastalar, Grup 1 (apne ağırlıklı OSA; apne indeksi (Aİ)≥ 2x hipopne indeksi (Hİ) ve Hİ≤ 15/sa), Grup 2 (hipopne ağırlıklı OSA; Hİ≥ 2x Aİ ve Aİ≤ 15/sa) ve Grup 3 (solunumsal olay dominansı olmayan -SODO- OSA; diğer solunumsal kriterleri karşılamayan) olmak üzere üç grupta değerlendirildi. Bulgular: Grup 1’de 65, Grup 2’de 58, Grup 3’te 90 hasta vardı. Gruplar arasında cinsiyet, yaş dağılımı (p> 0,05), vücut kitle indeksi açısından fark yoktu (p> 0,05). Apne ağırlıklı OSA’lıların daha sık tarif ettiği tanıklı apne (p= 0,042) semptomu dışında gruplar arasında uykuda solunum bozukluğu ile ilişkili semptomların dağılımı ile eşlik eden hastalıkların sıklığı açısından fark yoktu (p> 0,05). Apne ağırlıklılarda, hipopne ağırlıklılara kıyasla N2 yüzdesi ve arousal indeksi daha yüksek olması (sırasıyla; p= 0,009, p= 0,011) dışında gruplar arasında uyku mimarisi açısında fark yoktu. Hem AHİ hem de apne süreleri, apne ağırlıklılarda diğer iki gruptakilerine kıyasla anlamlı olarak yüksekti (sırasıyla; p= 0,000, 0,000, 0,000), total oksijen satürasyon indeksi (ODİ) ile NREM ODİ ve REM ODİ daha yüksek (sırasıyla; p= 0,000, 0,000, 0,047) ve gece boyu saptanan minimum oksijen satürasyonu (SpO2) daha düşüktü (sırasıyla; p= 0,001). Sonuç: Apne ağırlıklı OSA’lıların hem AHİ hem de solunumsal olayların süreleriyle oksijenizasyon problemleri açısından daha ciddi OSA’lı olduğunu gördük. Bu farklılıkların OSA tedavisinde de yönlendirici olabileceğini düşünüyoruz.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	GULBAY B, Bulut B, Ayöz S, Acıcan T (2022). Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. , 187 - 196. 10.5578/tt.20229809
Chicago	GULBAY BANU,Bulut Barış,Ayöz Sümeyye,Acıcan Turan Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. (2022): 187 - 196. 10.5578/tt.20229809
MLA	GULBAY BANU,Bulut Barış,Ayöz Sümeyye,Acıcan Turan Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. , 2022, ss.187 - 196. 10.5578/tt.20229809
AMA	GULBAY B,Bulut B,Ayöz S,Acıcan T Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. . 2022; 187 - 196. 10.5578/tt.20229809
Vancouver	GULBAY B,Bulut B,Ayöz S,Acıcan T Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. . 2022; 187 - 196. 10.5578/tt.20229809
IEEE	GULBAY B,Bulut B,Ayöz S,Acıcan T "Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?." , ss.187 - 196, 2022. 10.5578/tt.20229809
ISNAD	GULBAY, BANU vd. "Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?". (2022), 187-196. https://doi.org/10.5578/tt.20229809

APA	GULBAY B, Bulut B, Ayöz S, Acıcan T (2022). Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. Tüberküloz ve Toraks, 70(2), 187 - 196. 10.5578/tt.20229809
Chicago	GULBAY BANU,Bulut Barış,Ayöz Sümeyye,Acıcan Turan Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. Tüberküloz ve Toraks 70, no.2 (2022): 187 - 196. 10.5578/tt.20229809
MLA	GULBAY BANU,Bulut Barış,Ayöz Sümeyye,Acıcan Turan Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. Tüberküloz ve Toraks, vol.70, no.2, 2022, ss.187 - 196. 10.5578/tt.20229809
AMA	GULBAY B,Bulut B,Ayöz S,Acıcan T Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. Tüberküloz ve Toraks. 2022; 70(2): 187 - 196. 10.5578/tt.20229809
Vancouver	GULBAY B,Bulut B,Ayöz S,Acıcan T Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?. Tüberküloz ve Toraks. 2022; 70(2): 187 - 196. 10.5578/tt.20229809
IEEE	GULBAY B,Bulut B,Ayöz S,Acıcan T "Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?." Tüberküloz ve Toraks, 70, ss.187 - 196, 2022. 10.5578/tt.20229809
ISNAD	GULBAY, BANU vd. "Is it important to know the predominant respiratory event in AHI for the management of patients with OSA?". Tüberküloz ve Toraks 70/2 (2022), 187-196. https://doi.org/10.5578/tt.20229809