| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3177708 | Sleep Medicine | 2009 | 7 Pages |
BackgroundContinuous positive airway pressure (CPAP) treatment in obstructive sleep apnea syndrome (OSAS) requires pressure titration usually performed during attended in-hospital polysomnography. This manual titration procedure is not well standardized. The aim of the study was to ascertain whether a new automatic titration device is as effective as standard manual titration in determining constant CPAP pressure.MethodsWe included 38 patients with a newly diagnosed OSAS. Participants were randomly assigned to attended in-laboratory manual titration and automatic titration in two consecutive nights. Fixed CPAP pressure was set at the optimal pressure determined during the second night. The follow-up period was 6 weeks. Main outcomes were apnea/hypopnea index (AHI) and Epworth sleepiness scale (ESS).ResultsAHI (manual: baseline 40.5 ± 21.5/h vs. treatment 6.4 ± 3.3/h (p < 0.001); automatic: 53.3 ± 28.1/h vs. 7.8 ± 3.3/h (p < 0.001)) and ESS (manual: 11.3 ± 4.7 vs. 8.8 ± 5.1 (ns); automatic: 11.5 ± 5.6 vs. 7.0 ± 3.8 (p < 0.05)) showed a similar improvement in both groups. Pressure recommendation by the device and the technician, although not statistically different (8.7 ± 2.9 vs. 9.0 ± 3.3 mbar), corresponded only in 50% of the patients.ConclusionsAutomatic titration effectively predicts constant CPAP pressure for long-term treatment when performed during an attended polysomnography. Careful evaluation of raw data and polysomnography recording is mandatory before choosing a fixed CPAP pressure after automatic titration.
