OBSTRÜKTİF UYKU APNE SENDROMUNDA CERRAHİ TEDAVİ UYGULANAN VE CERRAHİ UYGULANMAYAN HASTALARDA SÜREKLİ POZİTİF HAVAYOLU BASINCI (CPAP) BASINÇ PARAMETRELERİNİN KARŞILAŞTIRILMASI

Abstract

ABSTRACT Mehyettinov Elmettin, Comparison of Continuous Positive Airway Pressure (CPAP) Pressure Parameters in Patients With Obstructive Sleep Apnea Syndrome Treated With and Without Surgery, Hacettepe University Faculty of Medicine, Department of Otorhinolaryngology, Ankara, 2026. Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder characterized by recurrent upper airway collapse and associated with significant cardiovascular and neurobehavioral consequences. Continuous positive airway pressure (CPAP) therapy is accepted as the first-line treatment for OSAS; however, surgical treatment options are considered in patients who are unable to tolerate or refuse CPAP therapy. Nevertheless, clinical and polysomnographic data regarding patients in whom OSAS is not completely resolved after surgery and in whom CPAP therapy is reintroduced remain limited in the literature. The aim of this study was to evaluate the clinical and polysomnographic characteristics of patients with persistent CPAP requirement following OSAS surgery and to compare patients treated with surgery plus CPAP and those treated with CPAP alone. A total of 67 patients diagnosed with OSAS and presenting with a postoperative apnea–hypopnea index (AHI) ≥15 on polysomnography were included in the study. Patients were divided into two groups: surgery plus CPAP and CPAP alone. Demographic characteristics and preoperative and postoperative polysomnographic parameters were retrospectively analyzed. Comparison of postoperative parameters between the groups revealed that minimum oxygen saturation was significantly higher in the surgery plus CPAP group. In addition, prone position AHI values were significantly lower in the surgery plus CPAP group. However, no statistically significant differences were observed between the groups in terms of overall AHI, oxygen desaturation index (ODI), CPAP pressure requirement, or Uyku etkinliği. In patients with persistent CPAP requirement after surgery, residual disease burden was particularly associated with oxygenation and positional apnea parameters. In conclusion, this study demonstrates that OSAS surgery does not completely eliminate the disease in all patients and that CPAP therapy remains clinically relevant in the postoperative period. The addition of surgical treatment to CPAP therapy may provide beneficial effects on oxygenation and apnea burden in specific body positions, while it does not result in a significant change in CPAP pressure requirement. These findings support the concept that surgical and CPAP therapies should be considered complementary rather than mutually exclusive approaches in appropriately selected patients with OSAS. Keywords: Obstructive sleep apnea syndrome, OSAS surgery, CPAP, Polysomnography, Oxygen saturation