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

Abstract

An alternative treatment of sleep apnoea syndrome in patients in whom continuous positive airway pressure (CPAP) is ineffective or not tolerated, is bilevel treatment. For uncomplicated OSAS, auto-adjusting CPAP based on the forced oscillation technique (APAP_FOT) has proved to be equally as effective as constant CPAP, but is prefered by the patients. We therefore investigated the question whether, in the event of primary CPAP intolerance, high pressures (>=12 cmH2O) or mixed SAS (>=10% central respiratory disorders), APAP_FOT is as effective as bilevel therapy. 27 patients were treated (prospective randomized cross-over study) with bilevel and APAP_FOT for 6 weeks each. Both modalities significantly improved the respiratory disturbances (AHI: baseline 49±]27.3/h, bilevel 9.8±]12.5, p<0.01, APAPFOT 13.8±]13.2, p<0.01) and sleep quality (arousals: baseline 43±]28.3/h, bilevel 17.7±]8.8, p<0.01, APAP_FOT 20.5±]10.7, p<0.01), with no significant differences between the modalities. Under APAP_FOT, mean treatment pressure was substantially reduced (bilevel 8.3±]2.5, APAP_FOT 5.1±]1.7, p<0.01). The majority of patients gave preference to APAP_FOT for long-term treatment (21 vs. 6 patients, p<0.05). In patients with difficult-to-treat OSAS, APAP_FOT has proved to be just as effective as bilevel therapy, but has the advantage of meeting with greater acceptance.

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Citations should be made in the following way:
W. J. Randerath, W. Galetke, C. Rocholl, K. H. Rühle (Hagen, Germany). Auto-adjusting CPAP based on impedance versus bilevel pressure in difficult sleep apnoea syndrome. Eur Respir J 2002; 20: Suppl. 38, 169

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