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Copyright ©ERS Journals Ltd 2001
Importance of sleep stage- and body position-dependence of sleep apnoea in determining benefits to auto-CPAP therapy
Unité De Recherche Centre de pneumologie, Hôpital Laval, Université Laval, Québec, Canada
CORRESPONDENCE: F. Sériès, Centre de pneumologie, Hôpital Laval, 2725 Chemin Sainte Foy, Sainte Foy, G1V 4G5, Canada. Fax: 418 6554762
Keywords: diurnal somnolence, effective pressure level, positive pressure variability
Received: October 20, 1998
Accepted May 25, 2001
The influence of sleep stage- and body position-dependence of sleep apnoea on treatment efficacy and compliance between conventional continuous positive airway pressure (CPAP) and auto CPAP therapy was evaluated.
Thirty-three newly treated sleep apnoea hypopnoea syndrome (SAHS) patients were randomly allocated to conventional or auto-CPAP therapy. Six patients of each treatment group were classified as having sleep stage- and body position-dependent obstructive breathing abnormalities according to the results of the baseline sleep study.
After 3 weeks of treatment, the Epworth sleepiness score tended to be higher (p=0.08) and the ability to stay awake lower (p=0.02) in patients with dependent breathing abnormalities treated with fixed CPAP, than in the other patients. The effective pressure/time index was significantly lower in sleep stage- and body position-dependent patients treated with fixed CPAP, than in the other patients (p=0.02). The number of hours the machine was turned on and a positive pressure applied, tended to be smaller in dependent patients treated with fixed CPAP than in independent patients of this treatment group and in patients treated with auto-CPAP. A night-to-night variability index (VI) of positive pressure changes was obtained in the auto-CPAP group. This index significantly decreased with time in the dependent patients while it remained unchanged in the independent group.
It is concluded that auto-continuous positive airway pressure may have specific indications in a subset of obstructive sleep apnoea patients with sleep stage- and body position dependent nocturnal breathing abnormalities.
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