Effects of CPAP therapy withdrawal on exhaled breath pattern in obstructive sleep apnoea

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Author(s) Schwarz, Esther I., Sinues, Pablo M.L., Bregy, Lukas, Gaisl, Thomas, Gomez, Diego Garcia, Gaugg, Martin T., Suter, Yannick, Stebler, Nina, Nussbaumer-Ochsner, Yvonne, Bloch, Konrad E., Stradling, John R., Zenobi, Renato, Kohler, Malcolm
Publication Type Journal Items, Publication Status: Published
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Title Effects of CPAP therapy withdrawal on exhaled breath pattern in obstructive sleep apnoea
Author(s) Schwarz, Esther I.
Sinues, Pablo M.L.
Bregy, Lukas
Gaisl, Thomas
Gomez, Diego Garcia
Gaugg, Martin T.
Suter, Yannick
Stebler, Nina
Nussbaumer-Ochsner, Yvonne
Bloch, Konrad E.
Stradling, John R.
Zenobi, Renato
Kohler, Malcolm
Journal or Series Title Thorax
Volume Number 71
Issue Number 2
Start Page 110
End Page 117
ISSN 0040-6376
Publisher BMJ Publishing Group
Publication Place London
Publication Date 2016-02
Abstract Background Obstructive sleep apnoea (OSA) is highly prevalent and associated with cardiovascular and metabolic changes. OSA is usually diagnosed by polysomnography which is time-consuming and provides little information on the patient's phenotype thus limiting a personalised treatment approach. Exhaled breath contains information on metabolism which can be analysed by mass spectrometry within minutes. The objective of this study was to identify a breath profile in OSA recurrence by use of secondary-electrospray-ionization-mass spectrometry (SESI-MS).

Methods Patients with OSA effectively treated with CPAP were randomised to either withdraw treatment (subtherapeutic CPAP) or continue therapeutic CPAP for 2 weeks. Exhaled breath analysis by untargeted SESI-MS was performed at baseline and 2 weeks after randomisation. The primary outcome was the change in exhaled molecular breath pattern.

Results 30 patients with OSA were randomised and 26 completed the trial according to the protocol. CPAP withdrawal led to a recurrence of OSA (mean difference in change of oxygen desaturation index between groups +30.3/h; 95% CI 19.8/h, 40.7/h, p<0.001) which was accompanied by a significant change in 62 exhaled features (16 metabolites identified). The panel of discriminating mass-spectral features allowed differentiation between treated and untreated OSA with a sensitivity of 92.9% and a specificity of 84.6%.

Conclusion Exhaled breath analysis by SESI-MS allows rapid and accurate detection of OSA recurrence. The technique has the potential to characterise an individual's metabolic response to OSA and thus makes a comprehensible phenotyping of OSA possible.
DOI 10.1136/thoraxjnl-2015-207597
Additional Notes Published online 15 December 2015
Document Type Article
Publication Status Published
Language English
Assigned Organisational Unit(s) 03430
Organisational Unit(s)
NEBIS System Number 004338412
Source Database ID WOS-000368333000006
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@article{Schwrz2016,
  author = "Schwarz, Esther I. and Sinues, Pablo M.L. and Bregy, Lukas and Gaisl, Thomas and Gomez, Diego Garcia and Gaugg, Martin T. and Suter, Yannick and Stebler, Nina and Nussbaumer-Ochsner, Yvonne and Bloch, Konrad E. and Stradling, John R. and Zenobi, Renato and Kohler, Malcolm",
  title = "{E}ffects of {C}{P}{A}{P} therapy withdrawal on exhaled breath pattern in obstructive sleep apnoea",
  journal = "Thorax",
  year = 2016,
  volume = "71",
  number = "2",
  pages = "110--117",
  month = feb,
}


E-Citations record created: Mon, 15 Feb 2016, 15:30:04 CET