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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorGENTA, Pedro R.-
dc.contributor.authorSCHORR, Fabiola-
dc.contributor.authorEDWARDS, Bradley A.-
dc.contributor.authorWELLMAN, Andrew-
dc.contributor.authorLORENZI-FILHO, Geraldo-
dc.identifier.citationJOURNAL OF CLINICAL SLEEP MEDICINE, v.16, n.9, p.1531-1537, 2020-
dc.description.abstractStudy Objectives: Although obstructive sleep apnea results from the combination of different pathophysiologic mechanisms, the degree of anatomical compromise remains the main responsible factor. The passive pharyngeal critical closing pressure (Pcrit) is a technique used to assess the collapsibility of the upper airway and is often used as a surrogate measure of this anatomical compromise. Patients with a low Pcrit (ie, less collapsible airway) are potential candidates for non-continuous positive airway pressure therapies. However, Pcrit determination is a technically complex method not available in clinical practice. We hypothesized that the discrimination between low and high Pcrit can be estimated from simple anthropometric and polysomnographic indices. Methods: Men with and without obstructive sleep apnea underwent Pcrit determination and full polysomnography. Receiver operating characteristics analysis was performed to select the best cutoff of each variable to predict a high Pcrit (Pcrit >= 2.5 cmH(2)O). Multiple logistic regression analysis was performed to create a clinical score to predict a high Pcrit. Results: We studied 81 men, 48 +/- 13 years of age, with an apnea-hypopnea index of 32 [14-60], range 1-96 events/h), and Pcrit of -0.7 +/- 3.1 (range, -9.1 to +7.2 cmH(2)O). A high and low Pcrit could be accurately identified by polysomnographic and anthropometric indices. A score to discriminate Pcrit showed good performance (area under the curve = 0.96; 95% confidence interval, 0.91-1.00) and included waist circumference, non-rapid eye movement obstructive apnea index/apnea-hypopnea index, mean obstructive apnea duration, and rapid eye movement apnea-hypopnea index. Conclusions: A low Pcrit (less collapsible) can be estimated from a simple clinical score. This approach may identify candidates more likely to respond to non-continuous positive airway pressure therapies for obstructive sleep apnea.eng
dc.relation.ispartofJournal of Clinical Sleep Medicine-
dc.subjectobstructive sleep apneaeng
dc.subjectpharyngeal critical closing pressureeng
dc.subject.otherobstructive sleep-apneaeng
dc.subject.otherupper airway collapsibilityeng
dc.subject.otheroral appliance treatmenteng
dc.subject.othermandibular advancementeng
dc.titleDiscriminating the severity of pharyngeal collapsibility in men using anthropometric and polysomnographic indiceseng
dc.rights.holderCopyright AMER ACAD SLEEP MEDICINEeng
dc.subject.wosClinical Neurologyeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Fabiola:Univ Sao Paulo, Hosp Clin HCFMUSP, Heart Inst InCor, Lab Sono,Pulm Div, LIM 63, Sao Paulo, Brazil-, Bradley A.:Monash Univ, Dept Physiol, Sleep & Circadian Med Lab, Melbourne, Vic, Australia; Monash Univ, Sch Psychol Sci, Melbourne, Vic, Australia; Monash Univ, Monash Inst Cognit & Clin Neurosci, Melbourne, Vic, Australia-, Andrew:Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Div Sleep & Circadian Disorders, Boston, MA 02115 USA-
hcfmusp.relation.referenceBamagoos AA, 2016, SLEEP MED CLIN, V11, P343, DOI 10.1016/j.jsmc.2016.04.002eng
hcfmusp.relation.referenceColrain IM, 2013, SLEEP MED, V14, P830, DOI 10.1016/j.sleep.2013.05.009eng
hcfmusp.relation.referenceEckert DJ, 2013, AM J RESP CRIT CARE, V188, P996, DOI 10.1164/rccm.201303-0448OCeng
hcfmusp.relation.referenceEckert DJ, 2011, CLIN SCI, V120, P505, DOI 10.1042/CS20100588eng
hcfmusp.relation.referenceEdwards BA, 2016, AM J RESP CRIT CARE, V194, P1413, DOI 10.1164/rccm.201601-0099OCeng
hcfmusp.relation.referenceEdwards BA, 2016, SLEEP, V39, P1973, DOI 10.5665/sleep.6226eng
hcfmusp.relation.referenceEdwards BA, 2012, J PHYSIOL-LONDON, V590, P1199, DOI 10.1113/jphysiol.2011.223925eng
hcfmusp.relation.referenceGagnadoux F, 2009, EUR RESPIR J, V34, P914, DOI 10.1183/09031936.00148208eng
hcfmusp.relation.referenceGenta PR, 2011, J APPL PHYSIOL, V111, P1315, DOI 10.1152/japplphysiol.00508.2011eng
hcfmusp.relation.referenceGLEADHILL IC, 1991, AM REV RESPIR DIS, V143, P1300, DOI 10.1164/ajrccm/143.6.1300eng
hcfmusp.relation.referenceHosselet JJ, 1998, AM J RESP CRIT CARE, V157, P1461, DOI 10.1164/ajrccm.157.5.9708008eng
hcfmusp.relation.referenceJordan AS, 2014, LANCET, V383, P736, DOI 10.1016/S0140-6736(13)60734-5eng
hcfmusp.relation.referenceKirkness JP, 2008, J APPL PHYSIOL, V104, P1618, DOI 10.1152/japplphysiol.00045.2008eng
hcfmusp.relation.referenceKirkness JP, 2005, SLEEP, V28, P457, DOI 10.1093/sleep/28.4.457eng
hcfmusp.relation.referenceLam B, 2011, SLEEP BREATH, V15, P195, DOI 10.1007/s11325-011-0496-yeng
hcfmusp.relation.referenceMarques M, 2019, J PHYSIOL-LONDON, V597, P5399, DOI 10.1113/JP278164eng
hcfmusp.relation.referenceMcEvoy RD, 2016, NEW ENGL J MED, V375, P919, DOI 10.1056/NEJMoa1606599eng
hcfmusp.relation.referencePhillips CL, 2013, AM J RESP CRIT CARE, V187, P879, DOI 10.1164/rccm.201212-2223OCeng
hcfmusp.relation.referenceSchwartz AR, 1998, AM J RESP CRIT CARE, V157, P1051, DOI 10.1164/ajrccm.157.4.9706067eng
hcfmusp.relation.referenceSCHWARTZ AR, 1991, AM REV RESPIR DIS, V144, P494, DOI 10.1164/ajrccm/144.3_Pt_1.494eng
hcfmusp.relation.referenceSforza E, 1999, AM J RESP CRIT CARE, V159, P149, DOI 10.1164/ajrccm.159.1.9804140eng
hcfmusp.relation.referenceSforza E, 2000, AM J RESP CRIT CARE, V161, P347, DOI 10.1164/ajrccm.161.2.9810091eng
hcfmusp.relation.referenceSutherland K, 2014, J CLIN SLEEP MED, V10, P215, DOI 10.5664/jcsm.3460eng
hcfmusp.relation.referenceXie AL, 2013, J APPL PHYSIOL, V115, P22, DOI 10.1152/japplphysiol.00064.2013eng
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/63
LIM/63 - Laboratório de Investigação Médica em Sono

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