ABSTRACT
AIMS: 1) to evaluate automatic positive airway pressure (APAP) titration in a partially attended setting; 2) to verify whether APAP performance depends on the apnea-hypopnea and periodic limb movement indexes (PLMI). METHODS: 65 CPAP naïve subjects with a sleep disorder of breathing and daytime sleepiness underwent a standard polysomnography (first night), APAP titration (second night, partially attended), and a standard polysomnography using continuous positive airway pressure (CPAP) at the effective pressure (Peff) established from the APAP titration (third night) in a sleep disorder laboratory in a 400-bed community hospital. We examined the apnea-hypopnea index (AHI), sleep stages, arousals induced by respiratory events (RESPa) and PLM (PLMa), and oxygen saturation during the first and third nights on CPAP at the Peff. Patients were divided into three groups according to their AHI and PLMI. RESULTS: At the Peff defined using APAP on the third night, the mean AHI dropped from 29.6 +/- 21.8 to 3.1 +/- 3.4, and the RESPa index from 16.5 +/- 16.2 to 1.7 +/- 2.6. No differences emerged in sleep stages or spontaneous arousals (first vs third night). Overall, 92% of the patients met the standard for an acceptable outcome of positive pressure titration. Baseline AHI and PLMI did not affect the outcome of titration. CONCLUSIONS: In patients with mild to moderate OSAS and PLMS, APAP titration enables the optimal fixed pressure for CPAP home therapy to be determined in at least 90% of patients.
Subject(s)
Nocturnal Myoclonus Syndrome/physiopathology , Sleep Apnea, Obstructive/physiopathology , Adult , Aged , Airway Resistance , Arousal , Continuous Positive Airway Pressure/instrumentation , Electrocardiography , Electroencephalography , Electromyography , Electrooculography , Female , Humans , Italy , Male , Middle Aged , Movement , Nocturnal Myoclonus Syndrome/therapy , Polysomnography , Severity of Illness Index , Sleep Apnea, Obstructive/therapy , Sleep Stages , Treatment OutcomeABSTRACT
Borrelia burgdorferi, i.e. the etiologic agent of Lyme disease, has been causatively linked to sarcoidosis. To evaluate the possible role of this spirochete in the pathogenesis of sarcoidosis we tested for the presence of antibodies to B. burgdorferi on serum samples obtained from 21 sarcoid patients living in an Italian mountain area where Lyme borreliosis is endemic. No patient showed antibodies to B. burgdorferi. Our data does not substantiate the hypothesis that sarcoidosis may be a borreliosis.
