S A N T È • LÖW E N S T E I N S L E E P T H E R A PY D E V I C E S
Appendix 1 Pgs. 3-4
Restorative Sleep : Even with good compliance and effectively reduced AHI, increased daytime sleepiness remains a problem for up to 40 percent of patients (Antic et al., 2011). AHI is a poor predictor of improvement in daytime function (Kingshott R.N. et al., 2000), (Weaver, Woodson, & Steward, 2005), (Kirkham, Heckbert, & Weaver, 2015). Causes other than a persistent respiratory disorder may be responsible for continued poor sleep. An increased risk of reduced compliance exists for patients with insomnia because the patients consider the respiratory mask and the therapy device to be particular- ly bothersome. Insomnia persists in up to 30 percent of patients treated with PAP (Björnsdóttir E. et al., 2013), (Philip et al., 2017). Compared to AHI, hypnogram-based parameters with and without PAP therapy show that the amount of deep sleep has a higher correlation with an improvement in symptoms (McArdle N. & Douglas N.J., 2001), (Walsh et al., 2008), (Kasai T. et al., 2008). Even the extent of a fall in blood pressure in CPAP treatment correlates more strongly with improvements in the sleepiness scale than with improvements in AHI/ODI resulting from therapy (Robinson G.V., Langford B.A., Smith D.M., & Stradling J.R., 2008).
When symptoms improve, the patient is motivated to adhere to therapy. When compliance improves, therapy succeeds and thus the chain of events continues in a self-reinforcing feedback loop. Restorative Sleep is the true goal of PAP therapy.
prisma RECOVER: Estimation of deep sleep from breathing pattern The innovative prisma RECOVER algorithm continuously analyzes the patient ’ s breathing pattern during PAP therapy. Respiration during deep sleep is more stable than in all other sleep or wake stages (see Figure 2).
Figure 2: Stable breathing in deep sleep stage as compared to variable breathing in REM sleep; above: airflow [l/min]; below: relative minute volume [%]
Sleep Quality in CPAP/APAPTherapy
Made with FlippingBook Online newsletter