P229 Does establishing an early diagnosis of EDAC and initiating CPAP, after performing sleep studies have a role in improving QoL and lower the overall cost burden of the disease?

Background Excessive dynamic airway collapse (EDAC), is a known cause for dyspnoea, cough, exercise intolerance, and recurrent hospital admissions. It refers to the collapse of the airway lumen greater than 75% while still maintaining the cartilaginous structural integrity of the trachea. The diagnosis remains mostly incidental due to lack of awareness while performing a bronchoscopy. Aim To determine effects of EDAC and its links to sleep disordered breathing and effect of therapy and cost efficacy with CPAP. Methods Retrospective analysis of patients referred to sleep services at Royal Stoke University hospital who were diagnosed with EDAC and who underwent sleep studies to formally assess sleep disordered breathing Results 15 patients with a mean age at diagnosis of EDAC was 67.9 years with a male to female ratio of 1:2, mean BMI 34 (SD 7.37) and 47% were non-smokers. Initial presenting symptoms were cough (53.33%), Cough with breathlessness (26.66%), and breathlessness alone (20%). EDAC was suspected in 13% while in the remaining 87% the large airway collapse was a chance finding on CT. Surprisingly all patients had confirmed obstructive sleep apnoea with a mean (SD) AHI 33.2 (SD 22.80). All these patients were initiated on Auto CPAP, with a mean duration of 28.73 months and an average per day use of 6.83 hours. An improvement in AHI was found to average of 4.4% (86.76%) and a marked improvement in sleep disordered breathing 73.33%. Hospital admissions were looked at a six-month interval before and after initiation of CPAP. A marked decline in total number of hospital admissions was observed i.e. 90% reduction with 69.63% reduction in total duration of hospital stay. Conclusions EDAC should be considered as a cause/contributing factor to unexplained respiratory symptoms. Where EDAC is shown on CT, sleep studies may be indicated prior to the introduction of what appears to be the cost effective treatment of CPAP.