Optimizing Treatment Success in Sleep Apnea




Davis, Tyler
Elias, Christopher
Burgess, Lauren
Burk, John
Smith, Michael


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Abstract Purpose: Obstructive Sleep Apnea (OSA) is an exceedingly common disorder in America with estimates of disease prevalence ranging from 3-7% of the entire population, and it is likely that this is a gross underestimation. OSA is considered a multifactorial disorder with a diverse range of influences including developmental, environmental, and genetic factors. The current gold standard of treatment is Positive Airway Pressure (PAP). PAP treatment, while proven to be effective, is heavily influenced by many patient features. As a result, treatment success of OSA is difficult to predict and current standards do not take all the critical factors into account. The purpose of this study was to determine which patient traits can be used to predict treatment success. Methods: We performed a retrospective analysis (IRB #2018-019) of de-identified patient data from sleep studies in 150 patients over time to calculate a newly developed Treatment Success Index (TSI). TSI is a novel measure that comprehensively measures patient treatment success by combining Apnea Hypopnea Index derived from the sleep data (AHI, a clinical measurement of disease severity) and specific measures of patient PAP compliance. We performed predictive statistical analyses to determine how several different parameters affected the calculated TSI. Results: A linear regression was performed between BMI and TSI, which revealed a significant increase in treatment success secondary to increasing patient BMI (p=0.00002). In addition, patients were divided into three groups based on their length of treatment (LoTx), and a linear regression between the group average LoTx’s and their respective TSI’s revealed significant results (p=0.003). Conclusions: These findings present new insights into factors that best predict treatment efficacy for OSA and may assist in optimizing patient treatment. Future studies will expand the scope of the utility of TSI as a new measure of treatment efficacy for OSA.