Adherence of obstructive sleep apnoea syndrome patients to positive airway pressure therapy - 10-year follow-up.

PURPOSE: Continuous positive airway pressure (CPAP) is the most effective therapy for obstructive sleep apnoea syndrome (OSAS). Long-term adherence is necessary; however, it may be widely variable based on current literature, where the predicting factors are also not well defined. The aim of this study was to assess ten-year adherence to CPAP and to define factors influencing it. METHODS: In total, 107 patients (91 males) were enrolled in this study, with an average age of 53.5 years (SD 10.1), with CPAP therapy being indicated (Apnoea-Hypopnoea Index - AHI > 15). Anthropometric and social status data have been obtained as well as the average use of CPAP through device memory. RESULTS: Sufficient adherence (> 4 h per night) was found in 57% of patients in the first year with no subsequent significant change during the next 9 years. Adherence correlated significantly with the severity of OSAS - AHI (r = 0.321 over 5 years) and Epworth Sleepiness Scale (r = 0.317 over ten years) but did not correlate with the pressure used or the age of the patient. No statistically significant differences have been found between the sexes, the different mask groups, or the social status groups. CONCLUSION: Good adherence to CPAP therapy in OSAS patients is essential. According to our results, patients with more severe OSAS or more severe sleepiness seem to have better adherence.

Bilateral multiple pneumatocele as a rare late complication of COVID-19 pneumonia.

Pneumatocele is a cavity, which may develop rarely as a complication of pneumonia. It is more common in patients requiring ventilation support. After COVID-19 pneumonia, there are only several case reports described. Our case report is about a male patient without any serious commorbities. The patient had bilateral multiple pneumatocele which have formed in postacute phase of moderate course of COVID-19. Other possible causes have been exluded by a complex examination. During the follow-up there was a clear gradual spontaneous resorption of the finding. The patient is still in very good clinical condition.

A positive correlation between adipocyte fatty acid binding protein and epicardial fat thickness in patients with obstructive sleep apnoea - preliminary data.

BACKGROUND: Obstructive sleep apnoea (OSA) is considered an important risk factor of cardiovascular diseases (CVDs). Epicardial fat (EF) thickness and adipocyte fatty acid-binding protein (A-FABP) may be important links to accelerated atherosclerosis observed in patients with OSA. The aim was to evaluate the relationship between EF thickness and A-FABP levels in patients with OSA. METHODS: 66 patients (of which, 60 were males) of average age 55.6 ± 8.8 years, with newly diagnosed OSA were enrolled in this study. All patients underwent a sleep study, anthropometric parameters were measured, laboratory analysis and echocardiography with EF thickness measurements were collected. Patients were divided into two groups: Group 1: EF < 1mm; Group 2: EF > 1mm. RESULTS: Epicardial fat was present in 51 patients (77.3%). A positive correlation was found between A-FABP levels and % of body fat (r=0.452, p=0.0002). After adjusting to % of body fat, there was no significant difference found in A-FABP levels in the two groups divided. CONCLUSIONS: This study found a positive correlation between serum A-FABP level and % of body fat in patients with moderate to severe obstructive sleep apnoea. No significant difference was found between both groups.

High incidence of masked hypertension in patientswith obstructive sleep apnoea despite normal automatedoffice blood pressure measurement results.

INTRODUCTION: Obstructive sleep apnoea (OSA) is a well-known risk factor for masked hypertension (MH) and masked uncontrolled hypertension (MUCH). Automated ambulatory office blood pressure measurement (AOBP) might better correlate with the results of ambulatory blood pressure measurements (ABPM) compared to routine office blood pressure measurement (OBPM). The aim of this study was to compare the diagnostic rate of MH/MUCH when using OBPM and AOBP in combination with ABPM. MATERIAL AND METHODS: 65 OSA patients, of which 58 were males, (AHI > 5, mean 44.4; range 5-103) of average age 48.8 ± 10.7 years were involved in this study. Following MH/MUCH criteria were used; Criteria I: OBPM < 140/90 mm Hg and daytime ABPM > 135/85 mm Hg; Criteria II: AOBP < 140/90 mm Hg and daytime ABPM > 135/85 mm Hg; Criteria III: AOBP < 135/85 mm Hg and daytime ABPM > 135/85 mm Hg. RESULTS: MH/MUCH criteria I was met in 16 patients (24.6%) with criteria II being met in 37 patients (56.9%), and criteria III in 33 (51.0%), p < 0.0001. Both systolic and diastolic OBPM were significantly higher than AOBP; Systolic (mm Hg): 135.3 ± 12.3 vs 122.1 ± 10.1 (p < 0.0001); Diastolic (mm Hg): 87.4 ± 8.9 vs 77.1 ± 9.3 (p < 0.0001). AOBP was significantly lower than daytime ABPM; Systolic (mm Hg): 122.1 ± 10.1 vs 138.9 ± 10.5 (p < 0.0001); Diastolic (mm Hg): 77.1 ± 9.3 vs 81.6 ± 8.1 (p < 0.0001). Non-dipping phenomenon was present in 38 patients (58.4%). Nocturnal hypertension was present in 55 patients (84.6%). CONCLUSIONS: In patients with OSA there is a much higher prevalence of MH/MUCH despite normal AOBP, therefore it is necessary to perform a 24-hour ABPM even if OBPM and AOBP are normal.