What is included in the long-term monitoring of patients with sleep-disordered breathing (SDB)?

Updated: Feb 13, 2020
  • Author: Vittorio Rinaldi, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

It msut be remembered that n-CPAP does not cure or alter the underlying OSA but, rather, provides daily relief from the apneas, snoring, hypoxias, and consequent daytime symptoms. After long-term n-CPAP use, a carry-over effect is often noted; therefore, PSG results on the first day or two off n-CPAP look remarkably improved. However, this carry-over is short-lived, and it is usually the case that within 1 week, the snoring, apneas, hypoxias, and daytime symptoms return to their original level.

n-CPAP is highly successful in managing OSA, as long as it is used. Unfortunately, compliance with n-CPAP use is less than ideal: Only about half of the patients for whom it is prescribed use it for at least 4 hours a night on 5 of 7 nights. For this reason, regular follow-up visits are mandatory for ensuring continued successful treatment.

Some physicians see patients on a 3- to 4-month basis during their first year of n-CPAP use and yearly thereafter. Repeat sleep studies are obtained after major weight loss or gain or after major change in daytime symptoms. Many patients happily and successfully use n-CPAP for years. Others find sustained use impossible; these are the patients for whom surgery may be helpful. [63]

Even snorers whose PSG does not show SDB should be monitored periodically because they can progress to SDB with time, even without weight gain.


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