RT Journal Article
SR Electronic
T1 Randomized short-term trial of high span versus low span APAP for the treatment of obstructive sleep apnea
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3581
VO 42
IS Suppl 57
A1 Helder Novais e Bastos
A1 Ana Sofia Castro
A1 Tiago Pinto
A1 Anabela Marinho
A1 Maria Sucena
A1 Marta Drummond
A1 João Almeida
A1 João Winck
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3581.abstract
AB Background: Auto-titrating continuous positive airway pressure (APAP) devices have been developed to improve efficacy and compliance to treatment of patients with obstructive sleep apnea syndrome (OSAS). Since there are insufficient data on the optimal pressure range setting, we aimed in this study to compare the efficacy of treatment with high span versus low span APAP.Methods: Fifty-three newly diagnosed OSAS patients fulfilling the treatment criteria were randomized to receive high span (HS, range 4-15 cmH2O, n=25) or low span (LS, range 8-12 cmH2O, n=28) APAP. Patients were assessed at 1 and 3 months.Results: Mean (±SD) Epworth Sleepiness Scale (ESS) was 10.5±6.2 and median apnea-hypopnea index (AHI) was 31.9 (IQR, 23.1-46.4). There were no significant differences in gender distribution, age, body-mass index, cervical perimeter, ESS and AHI between groups. Overall, no significant differences were found at the 1st month assessment. After 3 months of APAP therapy, we again found no differences in air leakage or residual AHI. However, HS group proved less adherent than LS group, respectively with median 69.5% (IQR, 44-96) vs 96% (IQR, 83.5-98) of the nights using at least 4h (p=0.008) and mean usage 5.4±1.8 h/night vs 6.5±1.2 h/night (p=0.022). In LS group, 83.3% patients had 95th percentile pressure >11 cmH2O, although only 7.7% required to change maximum pressure setting beyond 12 cmH2O.Conclusions: Both pressure ranges appear to be equally effective to correct AHI and improve symptoms. However patients with high span APAP were less compliant to treatment, raising issues about the tolerability of wide pressure range settings of these devices.