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Predicting response to oxygen therapy in obstructive sleep apnoea patients using a 10-minute daytime test

David Wang, Keith K. Wong, Luke Rowsell, Garrick W. Don, Brendon J. Yee, Ronald R. Grunstein
European Respiratory Journal 2018 51: 1701587; DOI: 10.1183/13993003.01587-2017
David Wang
Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, AustraliaDept of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
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  • For correspondence: david.wang@sydney.edu.au
Keith K. Wong
Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, AustraliaDept of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
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Luke Rowsell
Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, Australia
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Garrick W. Don
Dept of Respiratory and Sleep Medicine, Royal North Shore Hospita, Sydney, Australia
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Brendon J. Yee
Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, AustraliaDept of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
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Ronald R. Grunstein
Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, AustraliaDept of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
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Abstract

There is no satisfactory treatment for obstructive sleep apnoea (OSA). Supplemental low-flow oxygen therapy (LFO2) has been shown to reduce hypoxaemia and is well tolerated by patients with OSA. However, oxygen therapy may be beneficial only to certain subsets of patients with OSA. In this study, we evaluated a 10-min awake ventilatory chemoreflex test in predicting individual OSA response to 2 months of LFO2 therapy.

At baseline, patients with OSA underwent ventilatory chemoreflex testing in the afternoon, prior to the overnight polysomnography. Subjects were reassessed with polysomnography after 2 months of nocturnal oxygen treatment.

20 patients with OSA completed the study. After 2 months of O2 treatment, changes in the apnoea–hypopnoea index (AHI) were significantly correlated with baseline CO2 ventilatory response threshold (VRT) and chemosensitivity (p<0.05). In predicting a fall in AHI, the area under the receiver operating characteristic curve (AUC) was 0.79 for VRT and 0.89 for chemosensitivity. When these two variables were combined in a logistic regression model, the prediction effect became stronger with an AUC of 0.97, sensitivity of 0.92 and specificity of 0.83.

Our awake ventilatory chemoreflex test could be considered a simple potential clinical tool to predict individual OSA response to oxygen therapy. It could provide a novel personalised medicine approach to OSA treatment.

Abstract

A 10-min daytime test may predict the efficacy of O2 in improving the severity of obstructive sleep apnoea http://ow.ly/KZfY30gUXOj

Footnotes

  • Support statement: D. Wang was supported by the NHMRC Project Grant (#1043633); L. Rowsell was supported by the NHMRC CRE NeuroSleep Scholarship (#1060992); R.R. Grunstein was supported by the NHMRC Senior Principal Research Fellowship. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Conflict of interest: None declared.

  • This study is registered as ANZCTR No: 12612000006842.

  • Received August 3, 2017.
  • Accepted October 7, 2017.
  • Copyright ©ERS 2018
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Predicting response to oxygen therapy in obstructive sleep apnoea patients using a 10-minute daytime test
David Wang, Keith K. Wong, Luke Rowsell, Garrick W. Don, Brendon J. Yee, Ronald R. Grunstein
European Respiratory Journal Jan 2018, 51 (1) 1701587; DOI: 10.1183/13993003.01587-2017

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Predicting response to oxygen therapy in obstructive sleep apnoea patients using a 10-minute daytime test
David Wang, Keith K. Wong, Luke Rowsell, Garrick W. Don, Brendon J. Yee, Ronald R. Grunstein
European Respiratory Journal Jan 2018, 51 (1) 1701587; DOI: 10.1183/13993003.01587-2017
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