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Comparison of Therapeutic Approaches to Addicted Patients With Central Sleep Apnea



Schoebel C1 ; Ghaderi A2 ; Amra B3 ; Soltaninejad F4 ; Penzel T5 ; Fietze I6
Authors
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Authors Affiliations
  1. 1. Department of Cardiology and Angiology, Center of Sleep Medicine, Charite – Universitatsmedizin Berlin, Berlin, Germany
  2. 2. Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Pulmonary Ward, Bamdad Respiratory and Sleep Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Pulmonary Ward, Isfahan University of Medical Sciences, Bamdad Respi ratory and Sleep Research Center, Isfahan, Iran
  5. 5. Center of Sleep Medicine, Charite –Universitatsmedizin Berlin, Berlin, Germany
  6. 6. Department of Cardiology and Pulmonology, Center of Sleep Medicine, Charite – Universitatsmedizin Berlin, Berlin, Germany

Source: Tanaffos Published:2018

Abstract

Background: Nowadays, the most practical approaches used to treat sleep apnea, are Continuous Positive Airway Pressure (CPAP), Bi-level Positive Airway Pressure therapy (BPAP), supplemental O2, servoventilation and/or a combination of these approaches simultaneously. However, each leads to different consequences in opioid related Central Sleep Apnea (CSA) patients. Given the high prevalence of CSA and frequently use of opioids worldwide, it seems that evaluation of the condition in these patients is required to determine their responsiveness to the above mentioned treatments and to choose the most appropriate therapy. Materials and Methods: This longitudinal cross-sectional study included 41 opioid related CSA patients who underwent a step-by-step protocol (including CPAP, CPAP + O 2 and BPAP) in which if the patient was nonresponsive to a treatment, the next therapy was applied. If the patient was nonresponsive to all of these approaches, only oxygen was administered. Finally, the collected data were analyzed with SPSS software (ver. 22). Results: Among 41 participants, the responsiveness to CPAP, CPAP+O 2 and BPAP were 41.5%, 14.6% and 39%, respectively versus 4.9% nonresponsive patients to all above mentioned therapies. In patients with CSA and opium addiction, the CPAP and BPAP were the most effective treatments. In this group of patients, better response in the presence of higher Apnea–Hypopnea Index (AHI) was observed to BPAP, whereas better response in patients with lower AHI was to CPAP+O 2 Conclusion: Accordingly, CPAP and BPAP are successful approaches to treat opioid related CSA patients in various medical conditions including long-run addiction course, concurrent smoking and addiction but it appears that further studies are essential. © 2018, Shaheed Beheshti University of Medical Sciences and Health Services. All rights reserved.
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