PT  - JOURNAL ARTICLE
AU  - N Skjodt
AU  - R S Platt
TI  - Persistent inspiratory flow limitation during positive airway pressure therapy
AID  - 10.1183/13993003.congress-2022.4239
DP  - 2022 Sep 04
TA  - European Respiratory Journal
PG  - 4239
VI  - 60
IP  - suppl 66
4099  - http://erj.ersjournals.com/content/60/suppl_66/4239.short
4100  - http://erj.ersjournals.com/content/60/suppl_66/4239.full
SO  - Eur Respir J2022 Sep 04; 60
AB  - Background: We have validated automated quantitative inspiratory flow limitation (IFL) analysis during positive airway pressure (PAP) therapy monitoring. IFL precedes hypopnea, snoring, and apnea during airway obstruction with sleep-disordered breathing. To which of these descending goals should PAP be titrated?Methods: Age, gender, height, body mass, neck circumference, and Epworth sleepiness score were noted. Recording time, body position, airflow, mask pressure, and pulse oximetry (SpO2) were monitored breath by breath using the Remmers Sleep Recorder (Sagatech Electronics Inc., Calgary, Canada) in 32 sequential patients referred for PAP therapy assessment. Respiratory disturbance index (RDI) and IFL were automatically scored. The relationship between RDI and IFL was assessed by xy plot, Spearman's rank correlation coefficient ρ, and k-means cluster analysis (R base 4.12, R cluster package 2.1.2).Results: Spearman's rank correlation coefficient ρ = 0.119868, p = 0.5119. Graphically and by k-means cluster analysis an outlier cluster (5 of 32) with low RDI (< 7.5/h) but very high IFL (> 50%) was confirmed. The main cluster had variable RDIs (0.20 to 20.0/h) with lower IFL (0.69 to 23.4%). In the outlier group recording time with SpO2 ≤ 90% ranged from only 0.7 to 11% compared to 0 to 94% in the main cluster.Conclusions: Patients with persistent IFL on PAP therapy do not have clinically elevated RDI or low SpO2 values. PAP therapy should be titrated to minimize the RDI.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 4239.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).