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Meas."],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    : Adherence to continuous positive airway pressure (CPAP) is often limited. The aim of the current work was to create a simulation tool to enable determination of the individual CPAP therapy time required to normalize apnea-hypopnea index (AHI) (&lt;5 events h\n                    <jats:sup>\u22121<\/jats:sup>\n                    ) in a cohort of OSA patients.\n                    <jats:italic>Approach<\/jats:italic>\n                    : Polygraphic studies of 1989 consecutive patients were analyzed. CPAP therapy was simulated in 5\u2009min intervals starting from the beginning of the night and continuing until the end. In simulation, events inside the simulated CPAP therapy periods were considered to be prevented. The cutoff points where AHI reached a normal level of\u2009\u2009&lt;\u2009\u20095 events h\n                    <jats:sup>\u22121<\/jats:sup>\n                    were determined for mild, moderate and severe OSA categories.\n                    <jats:italic>Main results<\/jats:italic>\n                    : The median values of the required simulated CPAP usage times to normalize the AHI values were 3.3\u2009h, 5.6\u2009h and 6.5\u2009h in the mild, moderate and severe OSA categories, respectively. However, there were great differences between individuals in the CPAP usage times required to normalize AHI.\n                    <jats:italic>Significance<\/jats:italic>\n                    : An arbitrary threshold for CPAP adherence (e.g. 4\u2009h) leaves many OSA patients with a significant residual AHI, which could explain why some clinical trials fail to show significant benefits. Thresholds for adherence should be adjusted based on the patient-specific distribution of obstruction events during the night.\n                  <\/jats:p>","DOI":"10.1088\/1361-6579\/aae7fe","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T11:13:47Z","timestamp":1543403627000},"page":"115009","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Required CPAP usage time to normalize AHI in obstructive sleep apnea patients: a simulation study"],"prefix":"10.1088","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8252-3996","authenticated-orcid":false,"given":"Antti","family":"Kulkas","sequence":"first","affiliation":[{"name":"Sein\u00e4joki Central Hospital"},{"name":"University of Eastern Finland"},{"name":"Author to whom any correspondence should be addressed."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-821X","authenticated-orcid":false,"given":"Timo","family":"Lepp\u00e4nen","sequence":"additional","affiliation":[{"name":"Kuopio University Hospital"},{"name":"University of Eastern Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0615-4118","authenticated-orcid":false,"given":"Sami","family":"Nikkonen","sequence":"additional","affiliation":[{"name":"Kuopio University Hospital"},{"name":"University of Eastern Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7556-5343","authenticated-orcid":false,"given":"Arie","family":"Oksenberg","sequence":"additional","affiliation":[{"name":"Loewenstein Hospital\u2014Rehabilitation Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3134-5138","authenticated-orcid":false,"given":"Brett","family":"Duce","sequence":"additional","affiliation":[{"name":"Princess Alexandra Hospital"},{"name":"Queensland University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5682-5747","authenticated-orcid":false,"given":"Esa","family":"Mervaala","sequence":"additional","affiliation":[{"name":"Kuopio University Hospital"},{"name":"University of Eastern Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8035-1606","authenticated-orcid":false,"given":"Juha","family":"T\u00f6yr\u00e4s","sequence":"additional","affiliation":[{"name":"Kuopio University Hospital"},{"name":"University of Eastern Finland"},{"name":"The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2018,11,27]]},"reference":[{"key":"pmeaaae7febib001","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1093\/sleep\/22.5.667","type":"journal-article","article-title":"Sleep-related breathing disorders in adults\u202f: recommendations for syndrome definition and measurement techniques in clinical research","volume":"22","author":"American Academy of Sleep Medicine Task Force","year":"1999","journal-title":"Sleep"},{"key":"pmeaaae7febib002","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1093\/sleep\/34.1.111","type":"journal-article","article-title":"The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA","volume":"34","author":"Antic","year":"2011","journal-title":"Sleep"},{"key":"pmeaaae7febib003","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.chest.2016.03.010","type":"journal-article","article-title":"Hypertension is associated with undiagnosed OSA during rapid eye movement sleep","volume":"150","author":"Appleton","year":"2016","journal-title":"Chest"},{"key":"pmeaaae7febib004","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1001\/jama.2012.4366","type":"journal-article","article-title":"Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial","volume":"307","author":"Barbe","year":"2012","journal-title":"JAMA"},{"key":"pmeaaae7febib005","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1164\/ajrccm.165.6.2003166","type":"journal-article","article-title":"A randomized controlled trial of continuous positive airway pressure in mild obstructive sleep apnea","volume":"165","author":"Barnes","year":"2002","journal-title":"Am. 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All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2018-07-02","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2018-10-12","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2018-11-27","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}