title: A Comparison of Different Success Definitions in Non-Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea Using Cardiopulmonary Coupling.
abstract: OBJECTIVE
  The definition and the criteria for the successful treatment of obstructive sleep apnea vary, depending on the study. This study aimed to compare different success criteria of non-continuous positive airway pressure (non-CPAP) treatment for obstructive sleep apnea in terms of sleep quality by using cardiopulmonary coupling.
  
  
  METHODS
  We included 98 patients who had been treated with sleep surgery or with a mandibular advancement device at our sleep clinic from January 2011 to March 2013. The success and failure groups were divided by 6 criteria that have been used in the literature. The validity of each of the 6 criteria was evaluated by cardiopulmonary coupling-based sleep quality.
  
  
  RESULTS
  The parameters of cardiopulmonary coupling indicated that sleep quality improved with non-CPAP treatment: low-frequency coupling decreased from 57.4% ± 17.7% to 46.9% ± 16.5%, whereas high-frequency coupling increased from 30.2% ± 17.1% to 37.4% ± 16.7%. In multiple regression analysis, only the criterion of a reduction in the apnea-hypopnea index greater than 50% was significantly associated with sleep quality improvement (p = 0.016; 95% confidence interval, 1.008-1.076 in the high-frequency coupling increment; p = 0.001; 95% confidence interval, 1.025-1.099 in the low-frequency coupling decrement).
  
  
  CONCLUSIONS
  Cardiopulmonary coupling analysis showed that a reduction in the apnea-hypopnea index of more than 50% might be the optimal criterion to determine the success or failure of non-CPAP treatment in terms of sleep quality.
authors.affiliation: Department of Otolaryngology, National Police Hospital, Seoul, Korea.
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Seung-No
authors.initials: SN
authors.lastname: Hong
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hong Joong
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chae-Seo
authors.initials: CS
authors.lastname: Rhee
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chul Hee
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: In-Young
authors.initials: IY
authors.lastname: Yoon
authors.affiliation: Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jeong-Whun
authors.initials: JW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000706:statistics & numerical data*; D008875:Middle Aged; D017286:Polysomnography; D012119:Respiration; D020181:Sleep Apnea, Obstructive / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: cardiopulmonary coupling; non-continuous positive airway pressure; obstructive sleep apnea; sleep quality; success criteria