RT Journal Article
SR Electronic
T1 Effects of CPAP therapy withdrawal on exhaled breath pattern in obstructive sleep apnoea
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 110
OP 117
DO 10.1136/thoraxjnl-2015-207597
VO 71
IS 2
A1 Esther I Schwarz
A1 Pablo Martinez-Lozano Sinues
A1 Lukas Bregy
A1 Thomas Gaisl
A1 Diego Garcia Gomez
A1 Martin T Gaugg
A1 Yannick Suter
A1 Nina Stebler
A1 Yvonne Nussbaumer-Ochsner
A1 Konrad E Bloch
A1 John R Stradling
A1 Renato Zenobi
A1 Malcolm Kohler
YR 2016
UL http://thorax.bmj.com/content/71/2/110.abstract
AB 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.Trial registration number NCT02050425 (registered at ClinicalTrials.gov).