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Daytime polysomnography to perform titration for upper airway stimulation in patients with obstructive sleep apnea.
Bosschieter, Pien F N; Schoustra, Emily; de Vries, Nico; Steinbusch, Meerie J L; Kasius, Kristel M; Ravesloot, Madeline J L.
  • Bosschieter PFN; Department of Otorhinolaryngology - Head and Neck Surgery , OLVG, Jan Tooropstraat 164, 1061AE, Amsterdam, the Netherlands. p.f.n.bosschieter@olvg.nl.
  • Schoustra E; Department of Otorhinolaryngology - Head and Neck Surgery , OLVG, Jan Tooropstraat 164, 1061AE, Amsterdam, the Netherlands.
  • de Vries N; Department of Otorhinolaryngology - Head and Neck Surgery , OLVG, Jan Tooropstraat 164, 1061AE, Amsterdam, the Netherlands.
  • Steinbusch MJL; Department of Oral Kinesiology, ACTA, MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.
  • Kasius KM; Faculty of Medicine and Health Sciences, Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.
  • Ravesloot MJL; Department of Otorhinolaryngology - Head and Neck Surgery , OLVG, Jan Tooropstraat 164, 1061AE, Amsterdam, the Netherlands.
Sleep Breath ; 26(2): 707-715, 2022 06.
Article in English | MEDLINE | ID: covidwho-1328647
ABSTRACT

PURPOSE:

Upper airway stimulation (UAS) is an innovative treatment for patients with obstructive sleep apnea (OSA). UAS titrations are performed 3 months after activation of the device to optimize its effectiveness. In general, these titrations are performed during an in-laboratory overnight polysomnography (PSG). However, overnight titrations are expensive and can be logistically challenging because they are labor-intensive which causes shortage of sleep technicians available for night shifts. In addition, recently, overnight PSGs were postponed and canceled due to the COVID-19 pandemic. We aimed to assess the feasibility of a daytime PSG to perform titration of UAS therapy as an alternative for a conventional overnight PSG.

METHODS:

We performed a prospective single-center observational cohort study. Patients were included when planned for UAS titration; this was approximately 6 months after UAS activation. Data on sleep architecture, patient experience, and respiratory outcomes were collected to evaluate the feasibility. An overnight follow-up PSG 12 months after implantation was used to compare sleep architecture and therapy response.

RESULTS:

Of 23 patients, four were excluded from analysis because of technical issues during PSG. Even though patients slept significantly shorter during the daytime PSG, this was enough time to complete the titration successfully with 30-min sleep in final therapeutic settings in 84% of the patients. Patients (94%) had a positive experience with the daytime titration. Respiratory outcomes were significantly reduced during titration and were maintained at the 12-month follow-up.

CONCLUSION:

Daytime titrations are a valuable alternative for conventional overnight titrations. Our findings suggest the implementation of daytime titrations as standard of care. This will contribute to easier logistics and better work circumstances for sleep technicians without jeopardizing titration quality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sleep Apnea, Obstructive / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Sleep Breath Journal subject: Neurology / Otolaryngology Year: 2022 Document Type: Article Affiliation country: S11325-021-02441-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sleep Apnea, Obstructive / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Sleep Breath Journal subject: Neurology / Otolaryngology Year: 2022 Document Type: Article Affiliation country: S11325-021-02441-w