Index Note: Page numbers of article titles are in boldface type. A Acquired central hypoventilation syndrome, NPPV in children with, 475 Acute cardiogenic pulmonary edema, PAP therapy in, 394 395 Adaptive servo-ventilation, for sleep apnea, 419 437 historical context, 420 422 technical and clinical aspects of available devices, 422 434 ResMed VPAP Adapt SV, 422 428 Respironics BIPAP AutoSV and BIPAP AutoSV Advanced, 428 434 Adherence, adjunctive therapy to improve CPAP, 369 381 to positive airway pressure therapy, 321 334 authors experience with, 331 332 definition of compliance, 321 322 in the elderly, 326 interventions to improve, 326 330 change of PAP modality, 329 330 change of the interface, 328 heated humidification and inhale steroids, 327 328 patient education, behavioral therapy, and intensive monitoring, 326 327 use of sedatives during titration or for short term upon starting PAP, 330 monitoring of, 322 predictors of, 322 326 Adjunctive therapy, to CPAP, 369 381 heated humidification, 373 375 hypnotics and sedatives, 369 373 miscellaneous, 377 379 supplemental oxygen, 375 377 Adverse effects, of CPAP, treatment of, 330 331 Amyotrophic lateral sclerosis, NPPV therapy for, 459 462 APAP. See Auto-titrating positive airway pressure. Arnold-Chiari malformation II, noninvasive positive pressure ventilation in children with, 475 Arrhythmias, effects of CPAP on, 386 388 Auto-titrating positive airway pressure (APAP), and alternative titration methods, 361 368 advanced titration methods, 365 historical perspective, 361 other titration methods, 365 regulation, reimbursement, and the provider, 365 366 Sleep Med Clin 5 (2010) 507 512 doi:10.1016/s1556-407x(10)00073-1 1556-407X/10/$ see front matter ª 2010 Elsevier Inc. All rights reserved. scientific evidence, 362 365 bench studies, 362 clinical effectiveness, 362 365 technology, 361 362 change to, to improve compliance, 329 330 Automatic self-adjusting positive airway pressure. See Auto-titrating positive airway pressure (APAP). B Behavioral therapy, to improve compliance with CPAP therapy, 326 327 Bilevel positive airway pressure (BPAP), change to, to improve compliance, 329 models for NPPV, 486 487 titration of, 340 343 for central sleep apnea, 342 343 for chronic obstructive pulmonary disease, 343 for neuromuscular disorders, 343 for obstructive sleep apnea, 341 342 indications for, 340 341 Blood gas abnormalities, treatment of, in pediatric sleep-disordered breathing, 444 BPAP. See Bilevel positive airway pressure. C C-reactive protein, improvement in vascular inflammation with CPAP treatment, 388 390 Carbon dioxide (CO 2 ), measurement of PCO 2 during NPPV titration and treatment, 495 496 Cardiovascular disease, CPAP effect on, 383 392 arrhythmias, 386 388 coronary artery disease, 385 386 hypertension, 383 385 platelet function, 388 vascular inflammation and endothelial function, 388 390 visceral fat, 390 Central hypoventilation, pathophysiology of, in children, 440 Central hypoventilation syndromes, in children, 472 473, 475 477 acquired, 475 congenital, 475 myelomeningocele/arnold-chiari malformation II, 475 sleep.theclinics.com
508 Index Central (continued) obesity hypoventilation syndrome, 475 476 Prader-Willi syndrome, 475 Central respiratory control disorders, NPPV for treatment of, 493 Central sleep apnea, BPAP titration for, 342 343 in patients with congestive heart failure, 396 400 alternative modes of CPAP in, 400 mechanisms of action of CPAP in, 399 400 treatment, 399 pathophysiology of, in children, 440 positive airway pressure treatment of, 407 417 complex sleep apnea, 412 414 prevalence, 412 414 treatment, 414 in patients taking opioids, 411 412 prevalence, 411 412 treatment, 412 in systolic heart failure, 408 411 prevalence, 408 409 treatment, 409 411 treatment-emergent, after CPAP titration for obstructive sleep apnea, 339 340 Children, NPPV for treatment of hypoventilation in, 471 484 initiation of, 477 sleep laboratory titration, 477 478 positive airway pressure therapy in, 439 449 diagnosis, 440 442 guidelines for, 444 446 mechanism of action, 442 newer therapies in development, 447 pathophysiology of sleep-disordered breathing, 439 440 central sleep apnea and central hypoventilation, 440 chronic respiratory failure, 440 obstructive sleep apnea syndrome, 439 440 practical goals of titration in the pediatric sleep laboratory, 442 444 special considerations, 446 447 for CPAP/BIPAP use, 446 for the neuromuscularly weak child, 446 447 surgical treatment, 442 treatment of blood gas abnormalities in sleep disordered breathing, 444 Chronic hypoventilation syndromes. See Hypoventilation. Chronic obstructive pulmonary disease (COPD), BPAP titration for, 343 NPPV therapy for stable, 452 455 comorbid conditions, 453 etiology and pathophysiology, 452 in acute decompensation, 453 455 sleep architecture and arterial oxygen saturation, 453 treatment of, 452 453 Chronic pulmonary disease. See Pulmonary disease, chronic. Chronic respiratory failure. See Respiratory failure, chronic. Complex sleep apnea, prevalence, 412 414 treatment, 414 Compliance. See Adherence. Congenital central hypoventilation syndrome, in children, NPPV for, 475 Congestive heart failure, positive airway pressure in, 393 405 acute cardiogenic pulmonary edema, 394 395 central sleep apnea, 396 399, 396 400 alternative modes of PAP therapy for, 400 mechanisms of action in, 399 400 treatment, 399 obstructive sleep apnea, 395 396 sleep disordered breathing, 395 Continuous positive airway pressure (CPAP). See also Positive airway pressure therapy. adjunctive therapy to, 369 381 heated humidification, 373 375 hypnotics and sedatives, 369 373 miscellaneous, 377 379 supplemental oxygen, 375 377 effect on cardiovascular disease, 383 392 arrhythmias, 386 388 coronary artery disease, 385 386 hypertension, 383 385 platelet function, 388 vascular inflammation and endothelial function, 388 390 visceral fat, 390 titration of, 338 340 indications, 338 treatment-emergent central sleep apnea, 339 340 Coronary artery disease, effects of CPAP in patients with and without, 385 386 CPAP. See Continuous positive airway pressure and Positive airway pressure therapy. Cystic fibrosis, NPPV in children with, 477 NPPV therapy for stable, 455 458 comorbid sleep conditions, 456 nocturnal oxygen treatment, 457 pathophysiology, 456 sleep architecture and gas exchange, 456 457
Index 509 D Duchenne muscular dystrophy, NPPV in children with, 476 NPPV therapy for, 462 463 E Education, patient, intensive, to improve compliance with CPAP therapy, 326 327 Elderly patients, compliance with CPAP therapy in, 326 Electromyography, respiratory muscle EMG during NPPV titration, 494 495 Endothelial function, improvement in with CPAP treatment, 388 390 F Fat, visceral, CPAP effect on, 390 H Heart failure, congestive. See Congestive heart failure. systolic, central sleep apnea in, 408 411 prevalence, 408 409 treatment, 409 411 Heated humidification, as adjunctive therapy to CPAP, 373 375 to improve compliance with CPAP therapy, 327 328 Hospital titration, of NPPV in children with hypoventilation, 477 478 Humidification, for NPPV titration and treatment, 496 Humidification, heated, as adjunctive therapy to CPAP, 373 375 to improve compliance with CPAP therapy, 327 328 Hypercapnic respiratory failure, in noncardiac medical disorders, NPPV therapy for, 451 470 in kyphoscoliosis, 458 459 in neuromuscular disorders, 459 466 in stable chronic obstructive pulmonary disease, 452 455 in stable cystic fibrosis, 455 458 positive airway pressure as treatment modality, 451 452 Hypertension, effects of CPAP on, 383 385 Hypnotics, as adjunctive therapy to CPAP, 369 373 Hypoventilation, adaptive servo-ventilation for sleep apnea, 419 437 central, pathophysiology in children, 440 in children, NPPV in treatment of, 471 484 central hypoventilation syndromes, 472 473, 475 477 acquired, 475 congenital, 475 myelomeningocele/arnold-chiari malformation II, 475 obesity hypoventilation syndrome, 475 476 Prader-Willi syndrome, 475 chronic pulmonary disease, 474 cystic fibrosis, 477 478 impact of obesity, 474 physiology of chronic respiratory failure, 471 472 sleep laboratory titration, 477 478 ventilatory muscle weakness and neuromuscular disease, 473 474, 476 477 NPPV titration and treatment initiation for chronic benefits of, 490 BPAP modes for, 486 487 follow-up of patients on, 502 goals of, 489 490 in different patient groups, 492 493 central respiratory control disorders, 493 neuromuscular disease, 493 obesity hypoventilation syndrome, 492 493 restrictive chest wall disorders, 493 indications for initiation of, 487 489 initiation of, 490 492 after titration with polysomnography, 491 without polysomnography, 491 492 titration with polysomnography, 493 502 I Inhaled steroids, to improve compliance with CPAP therapy, 327 328 Initiation, and titration of NPPV for chronic Interface, delivery, change in, to improve compliance with CPAP therapy, 328 Interleukin-6, improvement in vascular inflammation with CPAP treatment, 388 390 K Kyphoscoliosis, NPPV therapy for, 458 459 L Leaks, mask, interventions for during NPPV titration or treatment, 502
510 Index M Mask interfaces, for NPPV titration and treatment, 496 Mechanical ventilation, adaptive servo-ventilation for sleep apnea, 419 437 Monitoring, intensive, to improve compliance with CPAP therapy, 326 327 of patient compliance with CPAP therapy, 322 Muscle weakness, ventilatory, in children with neuromuscular disease, 473 474 Myasthenia gravis, NPPV therapy for, 463 465 Myelomeningocele, NPPV in children with, 475 Myopathies, congenital, NPPV in children with, 476 477 N Neuromuscular disorders, BPAP titration for, 343 NPPV in children with, 476 477 NPPV for treatment of central, 493 NPPV therapy for, 459 466 amyotrophic lateral sclerosis, 459 462 Duchenne muscular dystrophy, 462 463 myasthenia gravis, 463 464 postpolio syndrome, 465 466 special considerations for PPV in children with, 446 447 ventilatory muscle weakness in children with, 473 474 Noninvasive positive pressure ventilation (NPPV), for treatment of hypoventilation in children, 471 484 initiation of, 477 sleep laboratory titration, 477 478 in hypercapnic respiratory failure in noncardiac medical disorders, 451 470 in kyphoscoliosis, 458 459 in neuromuscular disorders, 459 466 in stable chronic obstructive pulmonary disease, 452 455 in stable cystic fibrosis, 455 458 positive airway pressure as treatment modality, 451 452 titration and treatment initiation for chronic benefits of, 490 BPAP modes for, 486 487 follow-up of patients on, 502 goals of, 489 490 in different patient groups, 492 493 central respiratory control disorders, 493 neuromuscular disease, 493 obesity hypoventilation syndrome, 492 493 restrictive chest wall disorders, 493 indications for initiation of, 487 489 initiation of, 490 492 after titration with polysomnography, 491 without polysomnography, 491 492 titration with polysomnography, 493 502 addition of supplemental oxygen, 501 adjustments for patient comfort and synchronization, 500 choosing and adjusting backup rate, 499 choosing inspiratory time, 499 500 dependence of oxygen concentration on flow rate, 501 502 mask and other interventions for leak, 502 mask interfaces and humidification, 496 measurement of PCO 2 during, 495 496 NPPV device and monitoring, 493 494 protocol, 496 498 respiratory muscle EMG, 494 495 use of ST and timed modes during, 498 499 VT-BPAP, 500 501 Noninvasive ventilation, adaptive servo-ventilation for sleep apnea, 419 437 Nutrition, in children on NPPV for hypoventilation, 479 480 O Obesity, in children, impact on respiratory system, 474 Obesity hypoventilation syndrome, NPPV for treatment of, 475 476, 492 493 in children with, 475 476 Obstructive sleep apnea, adjunctive therapy to CPAP for patients with, 369 381 APAP and alternative titration methods for, 361 368 BPAP titration for, 341 342 CPAP effect on cardiovascular disease, 383 392 CPAP titration for, 338 339 in patients with congestive heart failure, 395 396 positive airway pressure treatment of adult patients with, 347 359 Obstructive sleep apnea syndrome, pathophysiology of, in children, 439 440 Obstructive sleep apnea-hypopnea syndrome, adherence to PAP therapy in, 321 334 Opioids, central sleep apnea in patients taking, 411 412 Oxygen, supplemental, addition of, during NPPV titration or treatment, 501 as adjunctive therapy to CPAP, 375 377 with positive pressure therapy, titration of, 343 344
Index 511 P Patient education, intensive, to improve compliance with CPAP therapy, 326 327 Pediatrics, NPPV in treatment of hypoventilation in children, 471 484 positive airway pressure therapy in children, 439 449 Platelet function, effects of CPAP on, 388 Polysomnography, NPPV titration with, 493 502 NPPV treatment initiated after titration with, 491 NPPV treatment initiated without, 491 492 Positive airway pressure (PAP) therapy, 321 505 adaptive servo-ventilation for sleep apnea, 419 437 adherence to, 321 334 auto-titrating (APAP) and alternative titration methods, 361 368 continuous (CPAP), 335 346, 369 381, 383 392 adjunctive therapy to, 369 381 and bilevel (BPAP) titration, 335 346 effect on cardiovascular disease, 383 392 for central sleep apnea, 407 417 in adult patients with obstructive sleep apnea, 347 359 in children, 439 449 in congestive heart failure, 393 405 noninvasive positive pressure ventilation (NPPV), 451 470, 471 484, 485 505 for treatment of hypoventilation in children, 471 484 in hypercapnic respiratory failure in noncardiac medical disorders, 451 470 titration and treatment initiation for chronic Postpolio syndrome, NPPV therapy for, 465 466 Prader-Willi syndrome, NPPV in children with, 475 Pressure relief CPAP, change to, to improve compliance with CPAP therapy, 329 Pulmonary disease, chronic, in children, 474 Pulmonary edema, acute cardiogenic, PAP therapy in, 394 395 R Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation syndrome (ROHHAD), NPPV in children with, 475 Regulation, of APAP devices, 365 366 Reimbursement, for APAP devices, 365 366 ResMed VPAP Adapt SV, 422 428 Respiratory control disorders, NPPV for treatment of central, 493 Respiratory failure, hypercapnic, in noncardiac medical disorders, NPPV therapy for, 451 470 in kyphoscoliosis, 458 459 in neuromuscular disorders, 459 466 in stable chronic obstructive pulmonary disease, 452 455 in stable cystic fibrosis, 455 458 positive airway pressure as treatment modality, 451 452 Respiratory failure, chronic, NPPV in treatment of hypoventilation in children, 471 484 central hypoventilation syndromes, 472 473, 475 477 acquired, 475 congenital, 475 obesity hypoventilation syndrome, 475 476 Prader-Willi syndrome, 475 chronic pulmonary disease, 474 cystic fibrosis, 477 478 impact of obesity, 474 physiology of chronic respiratory failure, 471 472 ventilatory muscle weakness and neuromuscular disease, 473 474, 476 477 pathophysiology of, in children, 440 Respironics BIPAP AutoSV, 428 434 Respironics BIPAP AutoSV Advanced, 428 434 Restrictive chest wall disorders, NPPV for treatment of, 493 ROHHAD syndrome, NPPV in children with, 475 S Sedatives, as adjunctive therapy to CPAP, 369 373 to improve CPAP compliance, 330 during titration, 330 for short term upon starting CPAP, 330 Sleep apnea, adaptive servo-ventilation for, 419 437 central. See Central sleep apnea. complex. See Complex sleep apnea. obstructive. See Obstructive sleep apnea. Sleep laboratory, pediatric, practical goals of positive pressure titration in, 442 444 titration of NPPV in children with hypoventilation, 477 478 Sleep-disordered breathing, in patients with congestive heart failure, PAP therapy in, 395 400 central sleep apnea, 396 400 obstructive sleep apnea, 395 396 pathogenesis of, 335 336 pathophysiology of, in children, 439 440 central sleep apnea and central hypoventilation, 440
512 Index Sleep-disordered (continued) chronic respiratory failure, 440 obstructive sleep apnea syndrome, 439 440 Spinal muscular atrophy, NPPV in children with, 476 Steroids, inhaled, to improve compliance with CPAP therapy, 327 328 Supplemental oxygen, addition of, during NPPV titration or treatment, 501 as adjunctive therapy to CPAP, 375 377 with positive pressure therapy, titration of, 343 344 Surgical treatment, of obstructive sleep apnea syndrome in children, 442 Systolic heart failure, central sleep apnea in, 408 411 prevalence, 408 409 treatment, 409 411 T Titration, CPAP and BPAP, 335 346 BPAP, 340 343 CPAP, 338 340 goals of, 337 optimal pressure, 336 preparation for, 337 338 split-night versus full-night study, 336 337 supplemental oxygen, 343 344 of NPPV, and treatment initiation for chronic Titration methods, alternative, 361 368 advanced methods, 365 other methods, 365 V Vascular inflammation, improvement in with CPAP treatment, 388 390 Ventilatory muscle weakness, in children with neuromuscular disease, 473 474 Ventilatory support, adaptive servo-ventilation for sleep apnea, 419 437 Visceral fat, CPAP effect on, 390 Volume-targeted bilevel positive airway pressure (VT-BPAP), 500 501