Two months auto-adjusting versus conventional nCPAP for obstructive sleep apnoea syndrome
Open accessAbstract
Autoadjusting nasal continuous positive airway pressure (CPAP) greatly reduces the apnoea/hypopnoea index (AHI), and affords a significant reduction in median pressure (P50) compared-with manually titrated conventional nasal CPAP. The aim of the present study was to test whether these benefits were maintained in the medium term at home, in a double-blind crossover study. Ten sequential subjects (mean AHI 52.9 x h(-1)) were enrolled. After a manual titration, subjects were randomly allocated to 2 months autoadjusting nasal CPAP (AutoSet), followed by 2 months with the AutoSet device in fixed pressure mode at the manually titrated pressure, or vice versa. The machine-scored AHI, P50, and median leak were recorded on 12 nights in each arm, and averaged. Mean+/-SEM AHI was 4.0+/-0.3 x h(-1) in auto mode, and 3.7+/-0.3 x h(-1) in manual mode (NS). Mean+/-SEM P50 was 7.2+/-0.4 cmH2O auto, 9.4+/-0.6 cmH2O manual, average reduction 23+/-4% (p<0.0001). Auto "recommended" pressure was (mean+/-SEM) 10.1+/-0.5 cmH2O (p=0.04 with respect to manual) and peak pressure typically 1 cmH2O higher. Median (+/-SEM) leak was 0.181+/-0.006 L x s(-1) auto (and uncorrelated with AHI or pressure), 0.20+/-0.006 L x s(-1) manual (p=0.003). Compliance was 6.3+/-0.4 h in auto mode and 6.1+/-0.5 h in fixed mode (NS). Apnoea/hypopnoea index during 2 months of home autoadjusting nasal continuous positive airway pressure is comparable to that during conventionally titrated fixed pressure continuous positive airway pressure, while affording a 23% reduction in median pressure but no increase in compliance. Leak did not importantly affect autoadjustment.
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A meta-analysis of 6 studies demonstrated no clinically significant difference in percent of nights PAP was used.
“In addition, a meta-analysis of 6 of these studies demonstrated no clinically significant difference in percent of nights PAP was used.186,189,191,192,206,208”
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- Authors
- Teschler, H., Wessendorf, T. E., Farhat, A. A., Konietzko, N., & Berthon-Jones, M.
- Affiliations
- Ruhrlandklinik (DE)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2000-06
- Volume
- 15
- Issue
- 6
- Pages
- 990
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2131352837
- Semantic Scholar
- 46f1d1323d8a2f730d9b6bdf8e786c461a7c2f69
- Cited by
- 97
- References
- 11
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 5 · 2017: 3 · 2016: 6 · 2015: 3 · 2014: 3 · 2013: 2 · 2012: 3
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- nasal continuous positive airway pressure, obstructive sleep apnea, CPAP titration, apnea-hypopnea index, CPAP adherence, air leakage
- MeSH terms
- Adult, Aged, Hypoxia, Double-Blind Method, Home Nursing, Humans, Lung Compliance, Male, Masks, Middle Aged, Nose, Positive-Pressure Respiration, Polysomnography, Cross-Over Studies, Sleep Apnea, Obstructive
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