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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3324

Title: Variability of breathing during wakefulness while using CPAP predicts adherence.
Other Titles: CPAPアドヒランスの予測因子としてのCPAP装着下覚醒時の呼吸不規則性
Authors: Fujita, Yukio
Yamauchi, Motoo
Uyama, Hiroki
Kumamoto, Makiko
Koyama, Noriko
Yoshikawa, Masanori
Strohl, Kingman P.
Kimura, Hiroshi
Keywords: breathing regularity
continuous positive airway pressure adherence
obstructive sleep apnoea syndrome
predictive marker
respiratory physiology
Issue Date: 22-Feb-2017
Publisher: John Wiley & Sons, Inc.
Citation: Respirology Vol.22 No.2 p.386-393 (2017 Feb)
Abstract: BACKGROUND AND OBJECTIVE: The standard therapy for obstructive sleep apnoea (OSA) is continuous positive airway pressure (CPAP) therapy. However, long-term adherence remains at ~50% despite improvements in behavioural and educational interventions. Based on prior work, we explored whether regularity of breathing during wakefulness might be a physiologic predictor of CPAP adherence. METHODS: Of the 117 consecutive patients who were diagnosed with OSA and prescribed CPAP, 79 CPAP naïve patients were enrolled in this prospective study. During CPAP initiation, respiratory signals were collected using respiratory inductance plethysmography while wearing CPAP during wakefulness in a seated position. Breathing regularity was assessed by the coefficient of variation (CV) for breath-by-breath estimated tidal volume (VT ) and total duration of respiratory cycle (Ttot). In a derivation group (n = 36), we determined the cut-off CV value which predicted poor CPAP adherence at the first month of therapy, and verified the validity of this predetermined cut-off value in the remaining participants (validation group; n = 43). RESULTS: In the derivation group, the CV for estimated VT was significantly higher in patients with poor adherence than with good adherence (median (interquartile range): 44.2 (33.4-57.4) vs 26.0 (20.4-33.2), P < 0.001). The CV cut-off value for estimated VT for poor CPAP adherence was 34.0, according to a receiver-operating characteristic (ROC) curve. In the validation group, the CV value for estimated VT >34.0 confirmed to be predicting poor CPAP adherence (sensitivity, 0.78; specificity, 0.83). CONCLUSION: At the initiation of therapy, breathing regularity during wakefulness while wearing CPAP is an objective predictor of short-term CPAP adherence.
Description: 博士(医学)・乙第1391号・平成29年3月15日
© 2016 Asian Pacific Society of Respirology
This is the peer reviewed version of the following article: Respirology Vol.22 No.2 p.386-393 (2017 Feb), which has been published in final form at http://dx.doi.org/10.1111/resp.12900. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
URI: http://hdl.handle.net/10564/3324
ISSN: 13237799
Academic Degrees and number: 24601B1391
Degree-granting date: 2017-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2016年度

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