Abstract
Obstructive sleep apnea (OSA) is a disorder characterized by recurrent obstruction of the upper airways during sleep. The high prevalence of this disease led to propose new strategies based on the home evaluation and management of patients. The aim of this study was to compare unattended home-based protocol with attended in-laboratory analysis, in a sample of patients with high risk for moderate to severe OSA.
We enrolled 131 patients, who were randomly divided into 2 groups: group 1 (n=66) was diagnosed and titrated at home; group 2 (n=65) was analyzed in the sleep lab of our hospital. Diagnostic evaluations were carried out with portable monitoring at home, and with polysomnography in the sleep lab. Titration was performed with the same autoCPAP device in both groups.
At the end of the study, 13 (19%) subjects had dropped out in the group 1, and 9 (14%) in the group 2 (p= not significant). There were no significant differences among groups in both basal and with-CPAP values of apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and total sleep time with oxyhemoglobin saturation below 90% (TST90). In the home group, therapeutic pressure values reached at the end of each unattended home titration night were similar.
Home diagnosis and titration approach should be considered in a subset of patients with OSA. A single unattended titration night is sufficient to determine the therapeutic pressure.
- © 2012 ERS