Browsing by Author "Bachour, Adel"

Abstract (246 words) Purpose: No consensus exists regarding monitoring the initiation of positive airway pressure (PAP) by oximetry. A PAP device report may be insufficient to ensure a good therapeutic response in all patients. This study aimed to identify patients potentially benefitting from oximetry monitoring during PAP initiation. Methods: We routinely monitored PAP initiation at home with an oximeter. Here, we reviewed all patients undergoing PAP initiation in 2015, including a baseline sleep study and PAP initiation data. In group A we included patients with a residual AHI of <5/h and a residual ODI3 of ≥10/h. Group B included all remaining patients. We excluded cases with a leak of over 24 l/min or with an oximetry recording time of <1 hour. Residual AHI <5/h and residual ODI3 <10/h represented good PAP responses. Results: From 787 patients, we included 723 in this study. Among these, 158 had a residual AHI of ≥5/h, while 565 had a residual AHI of <5/h. Group A consisted of 129 (18%) patients. The sensitivity of the PAP device indicating a good PAP response reached 93.1%, with a specificity of 37.2%, a negative predictive value of 96.2%, and a positive predictive value of 23.9% using body mass index (BMI) ≥30kg/m2 and baseline SpO2 <92% as the cut-off points. Conclusions: Relying only on the PAP device parameter to evaluate therapeutic responses provided inconsistent results in one-fifth of cases. We recommend oximetry monitoring during PAP initiation when baseline SpO2 <92% or when BMI ≥30. Otherwise, oximetry monitoring remains optional.