title: The prediction of treatment failure of the continuous positive airways pressure.
abstract: OBJECTIVE
  The aim of study was to find predictive factors for treatment failure of the continuous positive airway pressure (CPAP).
  
  
  BACKGROUND
  Sleep apnea syndrome (SAS) affects 4-8 % of the general population. Despite good adherence, CPAP is ineffective in about 13 % of patients. In those patients, a higher level of treatment by bilevel positive airway pressure (BiPAP) has to be used.
  
  
  METHODS
  Totally, 983 patients with moderate to severe SAS (AHI ≥ 15, apnea/hypopnea index) were treated with CPAP during 2005-2010 in a tertiary hospital. 506 patients fulfilled the inclusion criteria. In all patients, sleep monitoring was performed and AHI, the presence of hyposaturation T90 (oxygen saturation less than 90 %) and ODI (oxygen distress index) were recorded and a comparison was made between CPAP-effective and CPAP-failure treatment groups.
  
  
  RESULTS
  Of all the variables evaluated, only T90 significantly predicted the failure of CPAP treatment. A T90 value above 43.5 % predicted CPAP failure in 94.5 % of patients regardless of age.
  
  
  CONCLUSIONS
  The value of T90 enables the determination of patients who will not benefit from CPAP treatment and BiPAP should be used as a treatment of the first choice (Tab. 2, Fig. 1, Ref. 31).
authors.forename: D
authors.initials: D
authors.lastname: Slouka
authors.forename: M
authors.initials: M
authors.lastname: Honnerova
authors.forename: V
authors.initials: V
authors.lastname: Hrabe
authors.forename: A
authors.initials: A
authors.lastname: Matas
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017286:Polysomnography; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000628:therapy*; D017211:Treatment Failure