{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:45:52Z","timestamp":1762508752108},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"S 02","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":548,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sleep Sci"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>\n          Objectives: Obstructive sleep apnea (OSA) is a common disease, often treated using continuous positive airway pressure (CPAP) therapy. In many cases, patients fail a CPAP titration study due to inadequate control of the apnea-hypopnea index (AHI, events\/hour) or due to treatment-emergent central sleep apnea (TE-CSA). We report our experience using a mode of non-invasive ventilation for alternative treatment of these patients.<\/jats:p><jats:p>\n          Material and Methods: We reviewed records of adults who had OSA with AHI\u226515 diagnosed on polysomnography (PSG) with failed CPAP titration and in whom titrations with average volume-assured pressure support (AVAPS) with auto-titrating expiratory positive airway pressure were performed.<\/jats:p><jats:p>\n          Results: Forty-five patients, age 57.9\u00b113.1 y, 26 males, body mass index (BMI) 40.2\u00b18.7kg\/m2. Reasons for CPAP titration failure included: TE-CSA (25, 55.6%) and inadequate control of AHI at maximum CPAP of 20cm H2O (20, 44.4%). Changes noted from baseline PSG to AVAPS titration: AHI: 65.3\u00b129.3 decreased to 22.3\u00b116.1 (p&lt;0.001). Median time SpO2 \u226488%: 63.7 to 6.9min (p&lt;0.001). In 16 patients the AHI was reduced to &lt;15 and in 16 additional patients the AHI was reduced to &lt;30. Improvement in AHI was not related to gender, age, or opioid use, but was correlated with BMI: \u2206AHI=12.2 - (1.4 * BMI); p=0.05. AVAPS resulted in improved sleep architecture: median N3 sleep increased: 1.4% to 19.6% total sleep time (TST) (p&lt;0.001), and median R sleep increased: 6.4% to 13.6% TST (p&lt;0.01).<\/jats:p><jats:p>\n          Discussion: For patients with OSA for whom CPAP titration failed, titration with AVAPS may be an effective treatment.<\/jats:p>","DOI":"10.5935\/1984-0063.20210015","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T14:48:16Z","timestamp":1646923696000},"page":"328-332","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Average volume-assured pressure support for patients with obstructive sleep apnea with failed CPAP titration"],"prefix":"10.1055","volume":"15","author":[{"given":"Naomitsu","family":"Watanabe","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Medicine - Baltimore - Maryland - United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M","family":"Levri","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Medicine - Baltimore - Maryland - United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor T","family":"Peng","sequence":"additional","affiliation":[{"name":"University of Maryland Medical Center Midtown Campus, Medicine - Baltimore - Maryland - United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven M","family":"Scharf","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Medicine - Baltimore - Maryland - United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Diaz-Abad","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Medicine - Baltimore - Maryland - United States."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,1]]},"container-title":["Sleep Science"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.5935\/1984-0063.20210015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T18:54:04Z","timestamp":1701456844000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.5935\/1984-0063.20210015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":0,"journal-issue":{"issue":"S 02","published-online":{"date-parts":[[2023,12,1]]},"published-print":{"date-parts":[[2022,6]]}},"URL":"https:\/\/doi.org\/10.5935\/1984-0063.20210015","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1984-0659","1984-0063"],"issn-type":[{"value":"1984-0659","type":"print"},{"value":"1984-0063","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}