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76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

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Esophageal pressure measurement in patients with obstructive sleep apnea syndrome (OSAS): helpful in the detection of the CPAP-pressure?

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  • corresponding author Richard de la Chaux - HNO-Klinik der Ludwig-Maximilians-Universität, München
  • Christine Klemens - HNO-Klinik der Ludwig-Maximilians-Universität, München
  • Alfred Dreher - HNO-Klinik der Ludwig-Maximilians-Universität, München
  • Gerd Rasp - HNO-Klinik der Ludwig-Maximilians-Universität, München

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno432

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno232.shtml

Published: September 22, 2005

© 2005 de la Chaux et al.
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Outline

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Introduction: Adjustment of sufficient nasal CPAP-therapy in patients with OSAS can be time-consuming and so a parameter, which can predict the adequate pressure would be desirable. The goal of our study was to find out if the esophageal pressure as a measure of the breathing effort during polysomnography is helpful for the prediction of the effective CPAP-pressure.

Methods: 20 patients with OSAS received diagnostic polysomnography with measurement of the esophageal pressure during the whole night. After introduction of nasal CPAP-therapy the connection between esophageal pressure and the effective nCPAP-pressure was examined.

Results: Mean nCPAP-pressure was 8,6 (+/- 2,4) mbar with an pretherapeutic apnea-hypopnea-index (AHI) of 44,7 (+/- 15,7). There was a poor correlation between the mean esophageal pressure (7200-9800 breaths per patient) on the one hand and the effective nCPAP-pressure on the other hand (Spearman correlation: r = 0,42; p < 0,05). This was similar to the poor correlation of the nCPAP-pressure and the AHI (r = 0,48; p < 0,05). A better correlation was seen between the maximum esophageal pressure and the nCPAP-pressure with r = 0,57 (p < 0,01).The best correlation in this small subgroup was seen between the body mass index and the nCPAP-pressure with r = 0,82 (p < 0,01). This correlation was not found in a larger collective. There was no influence of age of the patients to the required nCPAP-pressure.

Conclusion: Polysomnographic parameters as for example the AHI and the mean esophageal pressure are only of limited value for the prediction of the effective nCPAP-pressure in patients with OSAS. Maximum esophageal pressure perhaps in combination with other anatomical factors may be helpful for enclosing a certain pressure area.