Fapnea was a significant independent factor associated with REM_CPAP levels in the development group. Using the equation obtained from the analyses of the development group, the predicted CPAP levels were significantly correlated with REM_CPAP in the validation group and NREM_CPAP levels in both development and validation groups. In addition, the predicted CPAP level could detect CPAP levels < 8 cm H2O with approximately 70% sensitivity and specificity during REM sleep in a supine position. Therefore, Fapnea could be a candidate parameter for detecting patients with mild UA collapsibility.
UA collapsibility is the major pathophysiological factor in sleep-disordered breathing, which in turn depends on anatomical factors. Non-anatomical factors, such as breathing instability, arousability, and upper airway muscle response are involved in the development of OSA supposedly. Moreover, they are involved in the pathophysiology of OSA in patients with moderate to severe UA collapsibility. Nevertheless, the impact of non-anatomical factors is lower than that of anatomical factors. In contrast, some non-anatomical factors contribute more to the development of OSA in patients with mild UA collapsibility. Therefore, the modification of non-anatomical factors, such as the administration of oxygen, hypnotic medication, muscle function therapy and/or a combination of these methods could be a treatment choice in such patients. Therefore, it is clinically important to distinguish between patients with mild and moderate to severe UA collapsibility.
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