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Indication of CPAP without a sleep study in patients with high pretest probability of obstructive sleep apnea

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dc.contributor.author Nigro, Carlos Alberto
dc.contributor.author Borsini, Eduardo
dc.contributor.author Dibur, Eduardo
dc.contributor.author Larrateguy, Luis
dc.contributor.author Cazaux, Alexis
dc.contributor.author Elias, Carlos
dc.contributor.author de la Vega, Marcelino
dc.contributor.author Maggi, Silvana
dc.contributor.author Grandval, Sofía
dc.contributor.author Cambursano, Hugo
dc.contributor.author Visentini, Daniela
dc.contributor.author Blanco, Magali
dc.contributor.author Ernst, Glenda
dc.contributor.author Bledel, Ignacio
dc.contributor.author Nogueira, Facundo
dc.contributor.author Berrozpe, Elda Cecilia
dc.date.accessioned 2019-11-22T13:13:38Z
dc.date.available 2019-11-22T13:13:38Z
dc.date.issued 2019-10-12
dc.identifier.citation Nigro, C.A., Borsini, E., Dibur, E., Larrateguy, L., Cazaux, A., Elias, C., de la Vega, M., Berrozpe, C., Maggi, S., Grandval, S., Cambursano, H., Visentini, D., Blanco, M., Ernst, G., Bledel, I., Nogueira, F., 2020. Indication of CPAP without a sleep study in patients with high pretest probability of obstructive sleep apnea. Sleep Breath 24, 1043–1050. https://doi.org/10.1007/s11325-019-01949-6 en_US
dc.identifier.uri https://repositorio.fleni.org.ar/handle/123456789/115
dc.identifier.uri https://doi.org/10.1007/s11325-019-01949-6
dc.description.abstract OBJECTIVE: To evaluate the performance of clinical criteria (CC) for diagnosis and initiation of empirical treatment with continuous positive airway pressure (CPAP) in patients with suspected obstructive sleep apnea (OSA) compared with the treatment decision based on sleep studies (polysomnography or respiratory polygraphy), guidelines, and experience of participating physicians. METHODS: This was a simulated intention-to-treat study in a retrospective (G1) and prospective (G2) cohort. Four observers (two per group) called CC1 and CC2 reviewed the sleep questionnaires and indicated CPAP if the patients presented snoring, frequent apneas (≥ 3-4/week), body mass index (BMI) > 25 kg/m2, sleepiness (Epworth > 11), or tiredness (at least 3-4 times per week) and some comorbidity (hypertension, coronary/cerebrovascular event, diabetes). Ten independent observers formed two groups of five (FD1 and FD2) and were blinded to each other's opinion. These observers in FD1 and FD2 decided CPAP treatment based on guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) or guidelines of the American Academy of Sleep Medicine (AASM) and factored in their own opinion. Sensitivity (S), specificity (Sp), and positive/negative likelihood ratios (LR+/-) were calculated with the test method: CC1/2, and the reference method: majority decision of FD1/2. RESULTS: A total of 653 patients (264 women, 40%) were studied. Median age was 54 years, BMI 28 kg/m2, and apnea hypopnea index (AHI) 16.5 events/h. S ranged from 21 to 25% (p 0.60), Sp 96.1 to 97.6% (p 0.39), and LR+ of clinical criteria 6.4 to 8.9 (p 0.52). CONCLUSION: CPAP indication without a previous sleep study showed a low sensitivity (≅ 22%) but a specificity greater than 95% in patients with high pretest probability for OSA (snoring, report of frequent apneas, BMI > 25 kg/m2 and sleepiness or tiredness plus comorbidity). en_US
dc.language.iso eng en_US
dc.publisher Springer en_US
dc.rights info:eu-repo/semantics/openAccess
dc.rights.uri https://creativecommons.org/licenses/by/2.5/ar/
dc.subject Sleep Apnea Syndromes en_US
dc.subject Síndromes de la Apnea del Sueño en_US
dc.subject Sleep Apnea, Obstructive en_US
dc.subject Apnea Obstructiva del Sueño en_US
dc.subject Continuous Positive Airway Pressure en_US
dc.subject Presión de las Vías Aéreas Positiva Contínua en_US
dc.title Indication of CPAP without a sleep study in patients with high pretest probability of obstructive sleep apnea en_US
dc.type info:eu-repo/semantics/publishedVersion
dc.type info:eu-repo/semantics/article en_US
dc.description.fil Fil: Nigro, Carlos Alberto. Hospital Alemán de Buenos Aires. Sleep Lab. Pneumonology; Argentina.
dc.description.fil Fil: Borsini, Eduardo. Hospital Británico. Sleep Lab. Pneumonology; Argentina.
dc.description.fil Fil: Dibur, Eduardo. Hospital Alemán de Buenos Aires. Sleep Lab. Pneumonology; Argentina.
dc.description.fil Fil: Larrateguy, Luis. Centro Privado de Medicina Respiratoria; Argentina.
dc.description.fil Fil: Cazaux, Alexis. Centro Dr. Lázaro Langer; Argentina.
dc.description.fil Fil: Elias, Carlos. Instituto Médico Insares; Argentina.
dc.description.fil Fil: de la Vega, Marcelino. Hospital Privado Santa Clara de Asis; Argentina.
dc.description.fil Fil: Maggi, Silvana. CEMIC. Sleep Lab; Argentina.
dc.description.fil Fil: Grandval, Sofía. Sanatorio San Lucas; Argentina.
dc.description.fil Fil: Cambursano, Hugo. Centro Dr. Lázaro Langer; Argentina.
dc.description.fil Fil: Visentini, Daniela. Hospital Cetrángolo; Argentina.
dc.description.fil Fil: Blanco, Magali. Hospital Británico. Sleep Lab. Pneumonology; Argentina.
dc.description.fil Fil: Ernst, Glenda. Hospital Británico. Sleep Lab. Pneumonology; Argentina.
dc.description.fil Fil: Bledel, Ignacio. Hospital Británico. Sleep Lab. Pneumonology; Argentina. Hospital Alemán de Buenos Aires. Sleep Lab. Pneumonology; Argentina.
dc.description.fil Fil: Nogueira, Facundo. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas “José de San Martín”. Sleep Lab; Argentina.
dc.description.fil Fil: Berrozpe, Elda Cecilia. Fleni. Departamento de Neurología. Servicio de Sueño y Vigilia. Laboratorio de Sueño; Argentina.
dc.relation.ispartofVOLUME 24
dc.relation.ispartofNUMBER 0
dc.relation.ispartofPAGINATION 00
dc.relation.ispartofPAGINATION 1043–1050
dc.relation.ispartofCOUNTRY Alemania
dc.relation.ispartofCITY Titisee-Neustadt
dc.relation.ispartofTITLE Sleep Breath
dc.relation.ispartofISSN 1522-1709
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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