PT  - JOURNAL ARTICLE
AU  - Lisette Rohling
AU  - Michiel Eijsvogel
TI  - Alternative method for non-invasive automatic positive airway pressure therapy in OSAS patients
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3917
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3917.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3917.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: APAP has generally been accepted as an alternative to CPAP in the treatment of OSAS. Meta-analysis has shown that APAP can control OSAS as effectively as CPAP. It remains to be examined whether greater reductions of the mean pressure can be attained by using the lowest possible minimum level and by limiting the maximum pressure to a different extent [1].Objective: The aim of this study is to investigate whether a new adjusted mode of APAP lowers the mean applied pressure so compliance will increase.Method: New diagnosed OSAS patients are selected for a single blind randomized cross-over trial. Patients receive for 12 weeks two different PAP therapies, CPAP and restricted APAP (RAPAP). Prior to starting up PAP therapy patients receive a manual CPAP PSG titration. The titration night is used to set the CPAP and RAPAP. The RAPAP pressure is set 2 cmH2O around the titrated pressure [2]. After 6 weeks there is a transition to the other PAP therapy. Data is collected by questionnaires like ESS, Quebec Sleep Questionnaire (QSQ) and SF-36, REMstar Auto (Respironics) data, and home polygraphy.Results: 39 OSAS patients were recruited of which already 21 completed the study. After 6 weeks with RAPAP, the mean QSQ, ESS and AHI was improved significantly. Similar effects were achieved with CPAP. Compliance showed similarities between therapies (RAPAP: 6.6 [4.3–7.9] hr/night, p=0.13). The mean applied pressure during RAPAP was 8.5 [6.0–11.5] cmH2O and for CPAP 8.5 [5.5–12.4] cmH2O (p=0.17).Conclusion: Analysis of 21 patients showed that RAPAP and CPAP therapy has similar treatment effects in OSAS patients. RAPAP fits the current therapy.References:1. Randerath W. Respiration 2000;67:272.2. Netzer NC. Sleep Breath 2010.