Source: Annual Congress 2002 - Airway obstruction measurement (FOT - NEP) sleep and lung sound analysis
Disease area: Sleep and breathing disorders

Abstract

The purpose of this study was to verify whether automatic continuous positive airway pressure (autoCPAP) application in an unassisted environment and without simultaneous polysomnographic monitoring allows reliable pressure titration in newly diagnosed patients with obstructive sleep apnoea syndrome (OSAS).
Thirty subjects with newly diagnosed OSAS (AHI 56.4±]19,9 (SD) Epworth score 11.4±]6.9), after a short diurnal adaptation period to nasal ventilation, underwent a nocturnal polysomnography (PS-2 Compumedics, Abbotsford, Australia) during application of an autoCPAP machine (AutoSet T, ResMed, Sydney, Australia). After study initiation, a technician was allowed to intervene only if nasal mask had been pulled-off and had to be repositioned. If a CPAP level with normoxia and regular breathing was reached, CPAP titration was considered successful unless: a) sleep efficiency was <50%; b) supine sleep posture was maintained for <2 hours; c) REM sleep was absent.
Two subjects requested early CPAP discontinuation. In all but one subject, who was the most obese in the sample (BMI 48.8 Kg/m2) and had bronchial asthma, an effective CPAP level was reached. Three patients pulled-off the mask, requiring technician help. In no subject titration was considered unsuccessful due to low sleep efficiency or persistent lateral decubitus, while one subject showed no REM sleep.
These data indicate that, in most instances, CPAP autotitration in an unattended environment is feasible. EEG monitoring during autotitration, although rarely, may help to identify subjects who need to repeat a titration night. Some failures in titration may depend on machine ineffectiveness in patients with peculiar characteristics.

Rating:

Share or cite this content

Citations should be made in the following way:
O. Marrone, G. Insalaco, A. Salvaggio, G. Sciortino, G. Bonsignore (Palermo, Italy). Is attended polysomnography necessary for autoCPAP titration?. Eur Respir J 2002; 20: Suppl. 38, 320

Member's Comments

No comment yet.

Related content which might interest you: Is the second polysomnography of CPAP titration necessary? Preliminary study Source: Eur Respir J 2002; 20: Suppl. 38, 100s Year: 2002 Is it still relevant to consider polysomnography as essential for noninvasive ventilation titration? Source: Eur Respir J, 53 (5) 1900619; 10.1183/13993003.00619-2019 Year: 2019 Titration of CPAP without polysomnography is equally effective as auto-CPAP titration in patients with OSAS Source: Eur Respir J 2003; 22: Suppl. 45, 95s Year: 2003 When should you use polysomnography / polygraphs? Source: Annual Congress 2009 - Practical Workshop - Management of obstructive sleep apnoea Year: 2009 Therapeutic titration of a dental appliance during one night of polysomnography Source: Eur Respir J 2001; 18: Suppl. 33, 419s Year: 2001 Predicting the optimal CPAP setting in patients with sleep apnea: validation on 107 split-night polysomnograms Source: Eur Respir J 2007; 30: Suppl. 51, 471s Year: 2007 Comparative study of attended full polysomnography (AFP) and ambulatory recording in OSAS patients Source: Eur Respir J 2004; 24: Suppl. 48, 117s Year: 2004 Alternatives to polysomnography (polysomnography versus polygraphy) Source: 5th Sleep and Breathing Conference Year: 2019 Is polysomnography feasible and useful for hospitalized patients? Source: Eur Respir J 2004; 24: Suppl. 48, 571s Year: 2004 Pulse transit time as a component of unattended home sleep studies in patients offered CPAP therapy Source: Eur Respir J 2005; 26: Suppl. 49, 117s Year: 2005 Is one night of screening oximetry sufficient for OSA? Source: International Congress 2017 – What is new in respiratory and sleep physiology? Year: 2017 A systematic review and meta-analysis on the efficacy and safety of un-attended home auto-CPAP titration versus in-laboratory CPAP titration for moderate to severe obstructive sleep apnea Source: Sleep and Breathing Conference 2021 Year: 2021 Should children with hypertension and snoring be referred for polysomnography? Source: International Congress 2017 – What is the future for paediatric respiratory physiology and sleep? Year: 2017 Nocturnal video polysomnography and nocturnal polygraphy for the diagnosis of paediatric OSA Source: International Congress 2014 – Diagnosis of paediatric obstructive sleep apnoea (OSA) in settings with limited resources Year: 2014 Can non sleep specialists order ambulatory sleep apnea testing effectively? Source: Annual Congress 2010 - Screening for sleep-disordered breathing Year: 2010 Comparison between home and hospital set-up for unattended home-based polysomnography: A prospective randomised study Source: International Congress 2015 – To treat or not to treat, and how? Sleep-disordered breathing I Year: 2015 Can spirometry and plethysmography seated and supine measures in obese snorer patients be employed in deciding when to perform polysomnography? Source: Eur Respir J 2004; 24: Suppl. 48, 119s Year: 2004 Ambulatory diagnosis and CPAP titration in obstructive sleep apnea patients – can we take the pressure off the sleep lab? Source: Eur Respir J 2005; 26: Suppl. 49, 116s Year: 2005 Home-based monitoring versus in-lab polysomnography in diagnosing the sleep apnoea/hypopnoea syndrome Source: Eur Respir J 2002; 20: Suppl. 38, 32s Year: 2002 A comparison of sleep disordered breathing events detected by CPAP devices with in-lab polysomnography Source: Virtual Congress 2020 – Advance in treatments for sleep and breathing disorders and long-term adherence Year: 2020