title: Comorbidity modulates non invasive ventilation-induced changes in breath print of obstructive sleep apnea syndrome patients.
abstract: BACKGROUND
  In obstructive sleep apnea syndrome (OSAS), exhaled volatile organic compounds (VOCs) change after long-term continuous positive airway pressure (CPAP). The objective of the study was to verify whether changes in VOCs pattern are detectable after the first night of CPAP and to identify correlates, if any, of these changes.
  
  
  METHODS
  Fifty OSAS patients underwent a multidimensional assessment and breath print (BP) analysis through 28 sensors e-nose at baseline and after the first night of CPAP. Boxplots of individual BP evolution after CPAP and groups were compared by ANOVA and Fisher's exact t. Partial least square discriminant analysis (PLS-DA), with leave-one-out as cross-validation was used to calculate to which extent basal BP could predicts changes in apnea-hypopnea index (AHI).
  
  
  RESULTS
  CPAP was effective in all the patients (delta AHI 35.8 events/h; residual AHI 6.0 events/h). BP dramatically changed after a single-night CPAP and changes conformed to two well-distinguished patterns: pattern C (n = 29), characterized by consonant boxplots, and pattern D (n = 21), with variably discordant boxplots. The average number of comorbid diseases (1.55 [standard deviation, SD 1.0] in group C, 3.14 [SD 1.8] in group D, p < 0.001) and the prevalence of selected comorbidity (diabetes mellitus, metabolic syndrome, and chronic heart failure), were the only features distinguishing groups.
  
  
  CONCLUSIONS
  We found that BP change after a single night of CPAP largely depends upon comorbidity. Comorbidity likely contributes to phenotypic variability in OSAS population. BP might qualify as a surrogate index of the response to and, later, compliance with CPAP.
authors.affiliation: Chair of Geriatrics, Unit of Respiratory Pathophysiology, Campus Bio-Medico University, Via Alvaro del Portillo 200, 00128, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli Incalzi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pennazza
authors.forename: Simone
authors.initials: S
authors.lastname: Scarlata
authors.forename: Marco
authors.initials: M
authors.lastname: Santonico
authors.forename: Chiara
authors.initials: C
authors.lastname: Vernile
authors.forename: Livio
authors.initials: L
authors.lastname: Cortese
authors.forename: Elena
authors.initials: E
authors.lastname: Frezzotti
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.forename: Arnaldo
authors.initials: A
authors.lastname: D'Amico
mesh_terms: D000368:Aged; D015415:Biomarkers; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D062609:Electronic Nose; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D010349:Patient Compliance; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D013223:Statistics as Topic; D016896:Treatment Outcome; D055549:Volatile Organic Compounds / Q000032:analysis*
chemical_list: D015415:Biomarkers; D055549:Volatile Organic Compounds