Nocturnal cardiopulmonary polygraphy is a diagnostic method useful in establishing the diagnosis of obstructive sleep apnea syndrome when clinical suspicion is high. The cardio-respiratory polygraph is a portable device, which is mounted to the patient by means of sensors, and the patient can sleep at home connected to this device.
During the night the parameters necessary for establishing the diagnosis are recorded:
- airflow (recorded through the nasal cannula)
- oxygen saturation in arterial blood and ventricular allure (pulse oximetry)
- chest effort
- body position during sleep
After registration, it is necessary to interpret the nocturnal route by manual validation by the doctor.
The choice of the therapeutic variant in the case of obstructive sleep apnea syndrome is made according to the severity of the disease, taking into account the index of apnea-hypopnea, the clinical picture and the presence of the associated diseases, thus involving interdisciplinary collaboration (pneumologist, ENT, cardiologist, diabetes-nutritionist, etc.).
Continuous positive pressure nocturnal therapy (CPAP) applied through the nasal or oral-nasal interfaces (masks), represents the standard treatment for SASO patients and represents the first line therapy to be considered in this category of patients.
CPAP acts as a pneumatic brace that prevents airway collapse, a collapse that can only be prevented if the CPAP pressure level is higher than the pressure that caused the airway collapse. CPAP pressure that keeps the airways open is determined by night titration during polygraphy one night after the diagnosis.
The success of CPAP therapy is influenced by the patient-device interface, respectively the nasal or oro-nasal mask, which differs in model, size and adapts according to the patient.
Alternative therapies that refer to sleep hygiene, weight loss, exercise, or ENT surgery (but not in the severe forms of SASO) should not be neglected and should be considered for complex treatment of the patient with obstructive sleep apnea syndrome.