Highlights
- •OSA patients can be divided into a pure-OSA group and a mixed-OSA group.
- •Mixed-OSA is associated with older age, male sex, and a higher apnea–hypopnea index.
- •Mixed-OSA is associated with complex sleep apnea.
- •Mixed-OSA requires higher therapeutic CPAP pressure.
- •Mixed-OSA has a lower probability of optimal CPAP titration.
Abstract
Purpose
To determine whether obstructive sleep apnea syndrome (OSAS) patients with mixed sleep
apnea (MSA) have different clinical, polysomnographic, and continuous positive airway
pressure (CPAP) titration findings compared to OSAS patients without MSA.
Methods
We retrospectively reviewed the records of OSAS patients who had undergone CPAP titration
and categorized them into pure-OSA and mixed-OSA groups. Demographic features, daytime
sleepiness, and apnea severity were compared between the two groups using univariate
and multivariate analyses. CPAP titration findings were also compared between the
two groups.
Results
One hundred and ninety-five subjects (n = 126 pure-OSA; n = 69 mixed-OSA) were included in the analysis. Compared to the pure-OSA group, the mixed-OSA
group had a higher percentage of males (p = 0.003) and a higher body mass index (p = 0.044), Epworth Sleepiness Scale score (p = 0.028), and apnea–hypopnea index (AHI) (p < 0.001). In logistic regression analysis, older age, male sex, and higher body mass
index were independently associated with mixed-OSA before PSG study. When using AHI
as a covariable, the higher AHI with older age, male sex, and daytime sleepiness was
independently related to mixed-OSA. The mixed-OSA group had a higher percentage of
patients with complex sleep apnea, a lower percentage of patients with optimal titration,
and a higher titrated pressure than the pure-OSA group.
Conclusions
Severe OSA, older age, male sex, obesity, and daytime sleepiness were related to mixed-OSA.
Complex sleep apnea, less optimal titration, and a higher titrated CPAP were also
associated with MSA in OSAS patients.
Keywords
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Article info
Publication history
Published online: June 03, 2015
Accepted:
June 2,
2015
Received in revised form:
June 1,
2015
Received:
March 1,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
