WASHINGTON, May 22, 2017 /PRNewswire/ -- According to a
new ResMed-sponsored (NYSE:RMD) study, people with
treatment-emergent central sleep apnea (CSA) have a significantly
greater risk of terminating positive airway pressure (PAP)
treatment. Researchers found that 3.5 percent of patients had CSA
during the first 90 days of PAP therapy. The study, Trajectories
of Central Sleep Apnea during Continuous Positive Airway Pressure
and Association with Therapy Termination: A Big Data Analysis,
was presented today at the 2017 American Thoracic Society
International Conference.
This analysis highlights the importance of:
- Regularly monitoring patients to support adherence to
treatment
Untreated sleep apnea increases the risk of other
chronic diseases known for being prevalent with sleep apnea,
including drug-resistant hypertension (83 percent), morbid obesity
(77 percent), type 2 diabetes (72 percent) and stroke (62
percent)1.
- Early diagnosis of CSA to minimize risk of therapy
termination
Findings from the largest-ever study of patients
with treatment-emergent CSA, presented at the April 2017 European Respiratory Society and
European Society of Sleep Research conference showed that switching
treatment from continuous positive airway pressure (CPAP) to
adaptive servo-ventilation (ASV) therapy2 significantly
improved the patient's adherence to therapy. It also showed that
those with treatment-emergent CSA who switched from CPAP to ASV
used their therapy longer and had significantly fewer apneas
(breathing stoppages or reductions) during sleep.
"This study provides the most robust view available on the
prevalence of CSA in patients on PAP therapy," said Dr.
Carlos Nunez, ResMed's chief medical
officer. "The findings in this new research, combined with the
research presented in April 2017,
underscore the importance of keeping patients on therapy through
regular monitoring, and rethinking the conventional wisdom on
therapeutic options based on each patient's disease severity."
The new analysis defined three groups among patients with CSA –
emergent, persistent and transient – based on whether the condition
was present at the start of therapy or emerged during the first 12
weeks. All three groups showed a significantly higher risk of
terminating their therapy than those without CSA. The risk was
highest among the emergent group, whose CSA only became apparent
during treatment, and were 1.7 times more likely to terminate their
therapy than those without the condition.
About the Study
The study authors included:
Atul Malhotra, University of California San Diego, United States; Peter
Cistulli, University of Sydney,
Australia; and Jean-Louis Pépin, Grenoble Alpes University,
France.
A retrospective analysis used anonymous, aggregated
telemonitoring data from a U.S. positive airway pressure therapy
database, (ResMed AirView™) and analyzed it for the presence or
absence of CSA during CPAP therapy at baseline (week 1) and after
12 weeks.
Session data included weekly values by averaging within each
week for each patient. Defined patient groups were: OSA, emergent
CSA, persistent CSA and transient CSA. Groups were compared to
identify risk factors for different forms of CSA, and adherence and
therapy termination rates were determined.
Patients with any form of CSA during CPAP were at higher risk of
terminating therapy in the first 90 days versus those who did not
develop CSA (hazard ratio 1.7 for emergent CSA, 1.4 for persistent
CSA and 1.3 for transient CSA; all p<0.001).
About Central Sleep Apnea
Obstructive sleep apnea
(OSA) and central sleep apnea (CSA) are the two most common types
of sleep apnea, a condition that results in repetitive pauses in
breathing during sleep. OSA is a sleep disorder in which the throat
muscles relax, block the airways and stop the flow of breath during
sleep. CSA is a sleep disorder in which the brain does not transmit
the "breathe" signal to the muscles that control breathing during
sleep. In either situation, the lack of oxygen causes the person to
wake up to catch their breath and start breathing again,
interrupting continuous sleep. This may occur multiple times in an
hour.
In some patients with OSA, CSA may emerge and only become
apparent during CPAP therapy. This was recognized in the third
edition of the International Classification of Sleep Disorders and
called "treatment-emergent CSA".
About ResMed
ResMed (NYSE: RMD) changes lives with
award-winning medical devices and cloud-based software applications
that diagnose, treat and manage sleep apnea, chronic obstructive
pulmonary disease (COPD) and other chronic diseases. ResMed is the
global leader in connected care, with more than 3 million patients
remotely monitored every day. Our 5,000-strong team is committed to
creating the world's best tech-driven medical device company –
improving quality of life, reducing the impact of chronic disease,
and saving healthcare costs in more than 100 countries.
ResMed.com | Facebook | Twitter | LinkedIn
1 References: Gami AS et al. Circulation
2004, O'Keefe and Patterson, Obes Surgery 2004, Logan et al.
J. Hypertension 2001, O'Keeffe T and Patterson EJ. Obes Surg 2004,
Einhorn D et al. Endocr Pract 2007, Bassetti C and Aldrich M. Sleep 1999
2 ASV therapy is contraindicated in patients with
chronic, symptomatic heart failure (NYHA 2-4) with reduced left
ventricular ejection fraction (LVEF ≤ 45%) and moderate to severe
predominant central sleep apnea.
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SOURCE ResMed Inc.