A randomized cross‐over study of auto‐continuous positive airway pressure versus fixed‐continuous positive airway pressure in patients with obstructive sleep apnoea

TO, Kin W.; CHAN, Wing C.; CHOO, Kah L.; LAM, Wai K.; WONG, Kwan K.; HUI, David S.

doi:10.1111/j.1440-1843.2007.01138.x

Cited by 42Obstructive Sleep Apnea ResearchSleep and related disordersRespiratory Support and Mechanisms

A randomized cross‐over study of auto‐continuous positive airway pressure versus fixed‐continuous positive airway pressure in patients with obstructive sleep apnoea

Open access

TO, Kin W., CHAN, Wing C., CHOO, Kah L., LAM, Wai K., WONG, Kwan K., HUI, David S.·2008·Respirology

DOI 10.1111/j.1440-1843.2007.01138.x

Open this paper in CoChat — free account Open PDF

Abstract

Background and objectives: To compare the efficacy of auto‐CPAP (AutoSet Spirit, ResMed) versus fixed‐CPAP (S6 Elite, ResMed) in improving daytime sleepiness, health status, objective compliance and the ultimate treatment preference in patients with severe OSA. Methods: The study recruited 43 subjects aged 18–65 years with newly diagnosed severe OSA (AHI >30/h). Patients were initially treated with either auto‐CPAP or fixed‐CPAP for 2 months and then crossed over after a washout period of 1 week for another 2 months. Results: The study was completed by 41 patients. Results are presented as mean (SE). Use of auto‐CPAP in the first and the second month was significantly higher than that of fixed‐CPAP [129.7 (9.9) and 130.5 (10.7) h vs 115.2 (9.5) and 113.2 (9.4) h, P = 0.04 and 0.01], whereas mean hourly use per night was 4.3 and 4.4 h versus 3.8 and 3.7 h, respectively. The Epworth sleepiness scores improved after 1 month in both treatments (13.4 to 8.5 and 8.2, P < 0.01 for both). The Sleep apnoea quality of life index improved in the first month in both compared with baseline [4.6 (0.2) to 5.0 (0.2) for auto‐CPAP and 4.9 (0.2) for fixed‐CPAP, P = 0.01 and 0.04, respectively], with no difference between the two treatments. Nine and 30 patients preferred auto‐CPAP and fixed‐CPAP, respectively, at the end of the trial, whereas 14 and 25 patients would have chosen the same treatments if cost had not been a consideration. Conclusions: Auto‐CPAP and fixed‐CPAP were equally effective in improving symptoms and health status in patients with severe OSA. Usage was higher with auto‐CPAP, but more patients ultimately chose fixed‐CPAP.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1111/j.1440-1843.2007.01138.x

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

A total of 5 studies reported differences in side effects between APAP and CPAP.
“A total of 5 studies reported differences in side effects between APAP and CPAP.186,193,194,198,208”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [198]
In 4 studies, there was less pressure discomfort with APAP than CPAP, and in at least 2 studies, less nasal irritation or machine noise with APAP than CPAP.
“In 4 of these studies, 186,193,198,208 there was less pressure discomfort with APAP than CPAP, and in at least 2 of the studies, less nasal irritation 186,205 or machine noise 193,205 with APAP than CPAP.”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [198]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Sleep–Related Breathing Disorders in Adults: Recommendations for Syndrome Definition and Measurement Techniques in Clinical Research
(1999) · Sleep · doi:10.1093/sleep/22.5.667 · Cited by 5,147 · see citing works
Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678 · see citing works
Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
Yaggi, H. K., Concato, J., Kernan, W. N., Lichtman, J. H., Brass, L. M., & Mohsenin, V. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043104 · Cited by 3,004 · see citing works
Day–Night Pattern of Sudden Death in Obstructive Sleep Apnea
Gami, A. S., Howard, D. E., Olson, E. J., & Somers, V. K. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa041832 · Cited by 1,032 · see citing works
Comparison of therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnoea: a randomised prospective parallel trial
Jenkinson, C., Davies, R. J., Mullins, R., & Stradling, J. R. (1999) · The Lancet · doi:10.1016/s0140-6736(98)10532-9 · Cited by 826 · see citing works
The Effects of Coffee and Napping on Nighttime Highway Driving
Philip, P., Taillard, J., Moore, N. D., Delord, S., Valtat, C., Sagaspe, P., & Bioulac, B. H. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-11-200606060-00004 · Cited by 650 · see citing works
Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome
Engleman, H. M., Martin, S. E., Douglas, N. J., & Deary, I. J. (1994) · The Lancet · doi:10.1016/s0140-6736(94)91522-9 · Cited by 592 · see citing works
A Community Study of Sleep-Disordered Breathing in Middle-aged Chinese Men in Hong Kong
Ip, M., LAM, B. K., Lauder, I. J., Tsang, K. W. T., Chung, K., Mok, Y.-W., & Lam, W. K. (2001) · CHEST Journal · doi:10.1378/chest.119.1.62 · Cited by 447 · see citing works
Self-citation
Alternative Methods of Titrating Continuous Positive Airway Pressure
Masa, J. F., Jiménez, A. L., Duran, J., Capote, F., Monasterio, C., Mayos, M., Terán, J., Hernández, L., Barbé, F., Maimó, A., et al. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200312-1787oc · Cited by 327 · see citing works
Auto-Titrating Versus Standard Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea: Results of a Meta-analysis
Ayas, N., Patel, S. R., Malhotra, A., Schulzer, M., Malhotra, M., Jung, D., Fleetham, J. A., & White, D. P. (2004) · SLEEP · doi:10.1093/sleep/27.2.249 · Cited by 251 · see citing works
Magnetic Resonance Imaging of the Upper Airway in Obstructive Sleep Apnea before and after Chronic Nasal Continuous Positive Airway Pressure Therapy
Ryan, C. F., Lowe, L. A., Li, D., & Fleetham, J. A. (1991) · American Review of Respiratory Disease · doi:10.1164/ajrccm/144.4.939 · Cited by 246 · see citing works
Sleep {middle dot} 1: Obstructive sleep apnoea/hypopnoea syndrome: definitions, epidemiology, and natural history
Stradling, J. R. (2003) · Thorax · doi:10.1136/thx.2003.007161 · Cited by 220 · see citing works
Automated Continuous Positive Airway Pressure Titration for Obstructive Sleep Apnea Syndrome
Teschler, H., Berthon-Jones, M., Thompson, A. B., Henkel, A., Henry, J. N., & Konietzko, N. (1996) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.154.3.8810613 · Cited by 191 · see citing works
Practice Parameters for the Use of Auto-Titrating Continuous Positive Airway Pressure Devices for Titrating Pressures and Treating Adult Patients with Obstructive Sleep Apnea Syndrome
Littner, M. R., Hirshkowitz, M., Davila, D., Anderson, W. M., Kushida, C. A., Woodson, B. T., Johnson, S. F., & Wise, M. S. (2002) · SLEEP · doi:10.1093/sleep/25.2.143 · Cited by 181 · see citing works
Rapid Eye Movement-Related Disordered Breathing
Haba-Rubio, J., Janssens, J.-P., Rochat, T., & Sforza, E. (2005) · Chest · doi:10.1378/chest.128.5.3350 · Cited by 163 · see citing works
The Effects of Nasal Continuous Positive Airway Pressure on Platelet Activation in Obstructive Sleep Apnea Syndrome
Hui, D. S. C., Ko, F. W. S., Fok, J. P. C., Chan, M. C. W., Li, T. S., Tomlinson, B., & Cheng, G. Y.-M. (2004) · CHEST Journal · doi:10.1378/chest.125.5.1768 · Cited by 153 · see citing works
Self-citation
Comparison of Manual and Automatic CPAP Titration in Patients With Sleep Apnea/Hypopnea Syndrome
Lloberes, P., Ballester, E., Montserrat, J. M., Botifoll, E., Ramirez, A., Reolid, A., Gistau, C., & Rodriguez‐Roisin, R. (1996) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.154.6.8970366 · Cited by 117 · see citing works
A Long-term Randomized, Cross-over Comparison of Auto-titrating and Standard Nasal Continuous Airway Pressure
Hudgel, D. W., & Fung, C. (2000) · Sleep · doi:10.1093/sleep/23.5.1g · Cited by 112 · see citing works
Nasal CPAP reduces systemic blood pressure in patients with obstructive sleep apnoea and mild sleepiness
Hui, D. S. C., To, K. W., Ko, F. W. S., Fok, J. P. C., Chan, M. C., Ngai, J. C. L., Tung, A., Ho, C. W., Tong, M. W., Szeto, C., et al. (2006) · Thorax · doi:10.1136/thx.2006.064063 · Cited by 108 · see citing works
Self-citation
Response of Automatic Continuous Positive Airway Pressure Devices to Different Sleep Breathing Patterns: A Bench Study
Farré, R., Montserrat, J. M., Rigau, J., Trepat, X., Pinto, P., & Navajas, D. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2111050 · Cited by 106 · see citing works
Constant vs Automatic Continuous Positive Airway Pressure Therapy
d'Ortho, M.-P., Grillier-Lanoir, V., Levy, P., Goldenberg, F., Corriger, E., Harf, A., & Lofaso, F. (2000) · Chest · doi:10.1378/chest.118.4.1010 · Cited by 103 · see citing works
Automatic nasal continuous positive airway pressure titration in the laboratory: patient outcomes
Stradling, J. R., BARBOUR, C., Pitson, D., & Davies, R. J. O. (1997) · Thorax · doi:10.1136/thx.52.1.72 · Cited by 103 · see citing works
Comparative Study of Autotitrating and Fixed-Pressure CPAP in the Home: a Randomized, Single-Blind Crossover Trial
Hukins, C. (2004) · Sleep · doi:10.1093/sleep/27.8.1512 · Cited by 100 · see citing works
Comparison of three ways to determine and deliver pressure during nasal CPAP therapy for obstructive sleep apnoea
West, S. D. (2006) · Thorax · doi:10.1136/thx.2005.046300 · Cited by 93 · see citing works
AutoSet nasal CPAP titration: constancy of pressure, compliance and effectiveness at 8 month follow-up
Teschler, H., Farhat, A., Exner, V., Konietzko, N., & Berthon-Jones, M. (1997) · European Respiratory Journal · doi:10.1183/09031936.97.10092073 · Cited by 77 · see citing works
Sleep Structure Correlates of Continuous Positive Airway Pressure Variations During Application of an Autotitrating Continuous Positive Airway Pressure Machine in Patients With Obstructive Sleep Apnea Syndrome
Marrone, O., Insalaco, G., Bonsignore, M. R., Romano, S., Salvaggio, A., & Bonsignore, G. (2002) · CHEST Journal · doi:10.1378/chest.121.3.759 · Cited by 75 · see citing works
Constant vs Auto-Continuous Positive Airway Pressure in Patients With Sleep Apnea Hypopnea Syndrome and a High Variability in Pressure Requirement
Noseda, A., Kempenaers, C., Kerkhofs, M., Braun, S., Linkowski, P., & Jann, E. (2004) · Chest · doi:10.1378/chest.126.1.31 · Cited by 63 · see citing works
Evaluation of an auto-CPAP device for treatment of obstructive sleep apnoea
Ficker, J. H., Wiest, G. H., Lehnert, G., Wiest, B., & Hahn, E. G. (1998) · Thorax · doi:10.1136/thx.53.8.643 · Cited by 61 · see citing works
Can Continuous Positive Airway Pressure Therapy Improve the General Health Status of Patients With Obstructive Sleep Apnea?
Sin, D. D., Mayers, I., Man, G. C. W., Ghahary, A., & Pawluk, L. (2002) · CHEST Journal · doi:10.1378/chest.122.5.1679 · Cited by 60 · see citing works
Importance of sleep stage- and body position-dependence of sleep apnoea in determining benefits to auto-CPAP therapy
Sériès, F., & Marc, I. (2001) · European Respiratory Journal · doi:10.1183/09031936.01.98103501 · Cited by 53 · see citing works
Continuous Positive Airway Pressure Requirement During the First Month of Treatment in Patients With Severe Obstructive Sleep Apnea
Jokic, R., Klimaszewski, A., Sridhar, G., & Fitzpatrick, M. (1998) · CHEST Journal · doi:10.1378/chest.114.4.1061 · Cited by 46 · see citing works
Evaluation of Unattended Automated Titration To Determine Therapeutic Continuous Positive Airway Pressure in Patients With Obstructive Sleep Apneaa
Kessler, R., Weitzenblum, E., Chaouat, A., Iamandi, C., & Alliotte, T. (2003) · CHEST Journal · doi:10.1378/chest.123.3.704 · Cited by 42 · see citing works
Preference for fixed or automatic CPAP in patients with obstructive sleep apnea syndrome
MARRONE, O. (2004) · Sleep Medicine · doi:10.1016/j.sleep.2003.09.011 · Cited by 41 · see citing works
Sleep‐disordered breathing and continuous positive airway pressure compliance in a group of commercial bus drivers in Hong Kong
Hui, D. S. C., Ko, F. W. S., Chan, J. K. W., To, K. W., Fok, J. P. C., Ngai, J. C. L., CHAN, M. C. H., Tung, A., Chan, D. P. S., HO, C. W., et al. (2006) · Respirology · doi:10.1111/j.1440-1843.2006.00932.x · Cited by 40 · see citing works
Self-citation
Auto-CPAP Therapy for Obstructive Sleep Apnea: Induction of Microarousals by Automatic Variations of CPAP Pressure?
Fuchs, F. S., Wiest, G. H., Frank, M., Harsch, I. A., Schahin, S. P., Hahn, E. G., & Ficker, J. H. (2002) · SLEEP · doi:10.1093/sleep/25.5.512 · Cited by 39 · see citing works
Comparison of conventional nighttime with automatic or manual daytime CPAP titration in unselected sleep apnea patients: study of the usefulness of daytime titration studies
Lloberes, P., Rodrı́guez, B., Roca, A. P., Sagalés, M., de la Calzada, M. D., Giménez, S., Romero, O., & Sampol, G. (2004) · Respiratory Medicine · doi:10.1016/j.rmed.2003.12.014 · Cited by 34 · see citing works
Two months follow up of auto-CPAP treatment in patients with obstructive sleep apnoea
Boudewyns, A. N., Grillier-Lanoir, V., Willemen, M., Cock, W. A. D., de Heyning, P. V., & Backer, W. A. D. (1999) · Thorax · doi:10.1136/thx.54.2.147 · Cited by 32 · see citing works
A Chinese version of the Sleep Apnea Quality of Life Index was evaluated for reliability, validity, and responsiveness
Mok, W. Y. W., Lam, C. L. K., Lam, B., Cheung, M. T., Yam, L. Y.-C., & Ip, M. (2004) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2003.09.018 · Cited by 30 · see citing works
Effects of fixed compared to automatic CPAP on sleep in Obstructive Sleep Apnoea Syndrome
Resta, O., Carratù, P., Depalo, A., Giliberti, T., Ardito, M., Marrone, O., & Insalaco, G. (2004) · Monaldi Archives for Chest Disease · doi:10.4081/monaldi.2004.694 · Cited by 23 · see citing works
[Compliance with continuous positive airway pressure therapy in patients with sleep apnea/hypopnea syndrome].
Gallego, C. W., Dibur, E., Salomone, C., et al. (2004) · PubMed · Cited by 3 · see citing works

Flagged first, then by citations

Research works printed but not linked: 3

[2]2. Hui DS, Ko FW, Chan JK, To KW, Fok JP et al. Sleep dis- ordered breathing and CPAP compliance in a group of commercial bus drivers in Hong Kong. Respirology 2006; 11: 723-30.
[3]3. Stradling JR, Davies RJ. Sleep. 1: Obstructive sleep apnoea/hypopnoea syndrome: Definitions, epidemiol- ogy, and natural history. Thorax 2004; 59: 73-8.
[14]14. Stradling JR, Barbour C, Pitson DJ, Davies RJ. Automatic nasal CPAP titration in the laboratory: Patient outcomes. Thorax 1997; 52: 72-5.

Sorted by citations

Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment
Patil, S. P., Ayappa, I. A., Caples, S. M., Kimoff, R. J., Patel, S. R., & Harrod, C. G. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7638 · Cited by 721 · see citing works
Pressure modification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea
Smith, I., & Lasserson, T. J. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003531.pub3 · Cited by 151 · see citing works
Auto-titrating versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: a systematic review with meta-analyses
Ip, S., D'Ambrosio, C., Patel, K., Obadan, N., Kitsios, G. D., Chung, M., & Balk, E. M. (2012) · Systematic Reviews · doi:10.1186/2046-4053-1-20 · Cited by 148 · see citing works
A Pilot Study Assessing Adherence to Auto-Bilevel Following a Poor Initial Encounter with CPAP
Powell, E. D., Gay, P. C., Ojile, J. M., Litinski, M., & Malhotra, A. (2012) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.1658 · Cited by 46 · see citing works

Evaluation of mandibular advancement device placement based on levels of TNF-alpha in participants with obstructive sleep apnea: A clinical study
Solanki, N., Jurel, S. K., Singh, B. P., Chand, P., Kant, S., & Nigam, N. (2021) · Journal of Prosthetic Dentistry · doi:10.1016/j.prosdent.2021.10.031 · Cited by 4 · see citing works
Predictive factors of adherence in Patients with Obstructive Sleep Apnea Syndrome to Continuous Positive Airway Pressure Therapy in Romania
Burcea, R., & Mihaltan, F. D. (2023) · MAEDICA – a Journal of Clinical Medicine · doi:10.26574/maedica.2023.18.2.278 · Cited by 3 · see citing works
Adherence to and Complications of CPAP in Obstructive Sleep Apnea: Key Determinants
Bahammam, A. S., Hussain, A., & Alasmri, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-21653-9_82
P.1.i.017 Amelioration of affective disorders and quality of life in obstructive sleep apnea (OSA) patients following continuous positive airway pressure (CPAP) therapy
Paparrigopoulos, T. J., Economou, N.-T., Koutsourelakis, I., et al. (2009) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(09)70523-1 · Cited by 1 · see citing works
Angiogenic factors in obstructive sleep apnea syndrome (OSA). Effects of nasal continuous positive airway pressure treatment (CPAP)
Bouloukaki, I., Neofytou, E., Soulitzis, N., et al. (2010) · F1000Research · doi:10.7490/f1000research.583.1

Authors: TO, K. W., CHAN, W. C., CHOO, K. L., LAM, W. K., WONG, K. K., & HUI, D. S.
Affiliations: Chinese University of Hong Kong (HK)
North District Hospital (HK)
Corresponding author: HUI, David S.
ORCID: TO, Kin W.
CHOO, Kah L.
LAM, Wai K.
HUI, David S.
Venue: Respirology
Publisher: Wiley
Published: 2007-10-22
Volume: 13
Issue: 1
Pages: 79-86
ISSN: 1323-7799 (ISSN-L)
1440-1843
DOI: 10.1111/j.1440-1843.2007.01138.x
OpenAlex: W2008031832
Semantic Scholar: 534a2af26791bf97273ff0b8554b315d9eca74dc
Cited by: 42
References: 40
Citations by year: 2025: 1 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 3 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 4
FWCI: 2.89
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Respirology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords: obstructive sleep apnea, auto-CPAP, medication adherence, daytime sleepiness, Epworth Sleepiness Scale, quality of life, treatment crossover
MeSH terms: Adolescent, Adult, Aged, Health Status, Hong Kong, Humans, Middle Aged, Patient Compliance, Quality of Life, Severity of Illness Index, Treatment Outcome, Patient Satisfaction, Cross-Over Studies, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

A randomized cross‐over study of auto‐continuous positive airway pressure versus fixed‐continuous positive airway pressure in patients with obstructive sleep apnoea

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks