Source: Annual Congress 2005 - CPAP therapy
Disease area: Sleep and breathing disorders

Abstract

Introduction: Automatic Positive Airway Pressure (APAP) can be used in two different ways. APAP-therapy is an effective treatment for OSAS patients by varying pressure according to sleep stages and body position. Autotitration can be used to determine an optimal fixed level of CPAP for long-term treatment with conventional CPAP. We asked, whether the pressure profile of an APAP-therapy device can also identify a sufficient constant pressure.
Methods: 28 patients (8 female, 20 male; age 60,8±10,5 years; BMI 31,3±6,1 kg/m²) with OSAS were enrolled with a diagnostic polysomnography (PSG) followed by CPAP titration and a PSG under APAP-therapy in random order. For APAP-therapy we used a new device based on Forced Oscillation Technique (FOT), snore and flow signals (SOMNOsmart2®, Weinmann, Germany).
Results: APAP-therapy lowered the Apnea-Hypopnea-Index (AHI) from 40,1±24,7 h^-1 to 7,7±3,0 h^-1 (p<0,001). Mean APAP pressure was 6,6±2,2 and P95% 8,7±3,1 cm H₂O, respectively. Mean pressure during conventional CPAP night was 8,2±1,8 cm H₂O. Correlation between P95% and mean CPAP in the whole study group was high (r²=0,423), but comparison of fixed CPAP and difference P95% to fixed CPAP for each individual showed correspondence of ± 1cm H₂O in only 8 of 28 patients.
Conclusions: APAP therapy based on FOT, snore and flow signals is an effective treatment in OSAS patients. An APAP device using this distinct algorithm does not provide treatment equivalent to autotitration; we conclude, that it should use for its intended purpose.

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Citations should be made in the following way:
W. Galetke, K. Richter, N. Anduleit, W. Randerath (Solingen, Germany). Automatic nCPAP therapy is not equivalent to autotitration in the treatment of OSAS. Eur Respir J 2005; 26: Suppl. 49, 4608

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