Switch of Nocturnal Non-Invasive Positive Pressure Ventilation (NPPV) in Obstructive Sleep Apnea (OSA).

Background. Continuous positive airway pressure (CPAP) is considered the first-line treatment for patients with OSA, but Bilevel-PAP (BiPAP) therapy is a recognized option for noncompliant/unresponsive patients to CPAP. The present study was designed to evaluate the role of ResMed VAuto in the management of two different issues raised because of the Philips recall: the treatment of naïve noncompliant/unresponsive patients to CPAP (Group A) and the switch to VAuto for patients already on treatment with Philips Auto-BiPAP (Group B).

Anxiety and depressive symptoms on continuous positive airway pressure: long-term adherence in patients with sleep apnea syndrome.

Background: Obstructive sleep apnea (OSA) is often associated to mood disorders and anxiety symptoms that may influence negatively the treatment approach. However, the relationship between anxiety, depression and adherence to treatment is still unclear. We investigate the presence of anxiety and depressive symptoms in newly diagnosed OSA patients and the link between psychological symptoms and acceptance or adherence to CPAP after one year.

Microsleep as a marker of sleepiness in obstructive sleep apnea patients.

We hypothesized that: (a) the presence of microsleep (MS) during a Maintenance Wakefulness Test (MWT) trial may represent a reliable marker of sleepiness in obstructive sleep apnea (OSA) patients; (b) the number of MSs will be higher in sleepy versus non-sleepy patients with a borderline MWT mean sleep latency; and (c) scoring MS during MWT analysis may help physicians to recognize patients with a higher degree of sleepiness. We analysed the MWT data of 112 treatment-naïve OSA patients: 20 with short sleep latency (SL, sleep latency <12.8 min), 43 with borderline latency (BL, sleep latency between 12.

Sleep disturbances in patients admitted to a step-down unit after ICU discharge: the role of mechanical ventilation.

Background: Severe sleep disruption is a well-documented problem in mechanically ventilated, critically ill patients during their time in the intensive care unit (ICU), but little attention has been paid to the period when these patients become clinically stable and are transferred to a step-down unit (SDU). We monitored the 24-h sleep pattern in 2 groups of patients, one on mechanical ventilation and the other breathing spontaneously, admitted to our SDU to assess the presence of sleep abnormalities and their association with mechanical ventilation.

Methods: Twenty-two patients admitted to an SDU underwent 24-h polysomnography with monitoring of noise and light.

The relationship of daytime hypoxemia and nocturnal hypoxia in obstructive sleep apnea syndrome.

Question Of The Study: Prevalence and determinants of daytime hypoxemia in patients with obstructive sleep apnea (OSA) syndrome are not well established. The aims of this study, conducted in a large series of OSA patients, were to estimate the prevalence of daytime hypoxemia, to assess the reciprocal effects between daytime PaO2 and nocturnal SpO2, and to investigate the direct and indirect role of sleep apnea severity in determining feedback gas exchange abnormalities.

Materials And Methods: In 456 patients a daytime hypoxemia-nocturnal hypoxia feedback structural equations model was designed.

Effect of sleep on patient/ventilator asynchrony in patients undergoing chronic non-invasive mechanical ventilation.

Background: Patients who require home non-invasive ventilation (NIV) during sleep normally have the ventilation settings adjusted empirically during daytime wakefulness. However, patient-ventilator asynchrony may occur during sleep. To detect the incidence of ineffective efforts (IE) during the sleep compared to wakefulness, we studied 48 patients already enrolled in a long-term home NIV programme.