Source: Annual Congress 2002 - Auto-CPAP in sleep apnoea: clinical aspects
Disease area: Sleep and breathing disorders

Abstract

Rationale: Flow limitation is the pathophysiologic basis of OSA. We investigated SelfSet® (MAP, Martinsried, Germany), a CPAP device, which monitors airflow as a function of changing pressures to find the optimal CPAP.
Methods: 60 Patients with OSA were included. After a baseline polysomnographic recording (see table) a recording with the SelfSet® followed. The algorithm of the device antagonises flow limitation. Every 2 minutes a "miniset" manoeuvre is performed, i.e. CPAP increases by 2 H₂O and afterwards decreases by 4 H₂O. The airflow of 3 breaths before, during and after the miniset is measured by a pneumotachygraph. The minimum CPAP*, eliminating flow limitation, was determined. Finally in a split night 2 different constant CPAP levels were applied: In the 1. part the CPAP level* found by SelfSet®, in the 2. part additional 2 cm H₂O CPAP to test whether SelfSet® underestimated the required pressure.
Results: See table (# p< 0.00001, baseline vs 1. part split night)

	Baseline	1. part of split night	2. part of split night
CPAP [H2O]	-	8.6 ±]2.0	10.6 ±]2.0
RDI [1/h]	61.3 ±]23.7	16.7 ±]11.0#	16.8 ±]11.4
Apnea Index [1/h]	31.7 ±]19.6	4.0 ±]5.8#	4.8 ±]7.4

Conclusion: The pathophysiologic based algorithm of the SelfSet® device proved to be a feasible means to find the optimal constant CPAP to treat OSA in the majority of patients.

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Citations should be made in the following way:
B. Schönhofer, J. Kerl, S. Suchi, D. Köhler (Schmallenberg, Germany). Clinical application of a new pathophysiologic based device to titrate CPAP in patients with OSA. Eur Respir J 2002; 20: Suppl. 38, 168

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