Chest
Clinical Investigations: Sleep and BreathingUse of Conventional and Self-Adjusting Nasal Continuous Positive Airway Pressure for Treatment of Severe Obstructive Sleep Apnea Syndrome: A Comparative Study
Section snippets
Methods
Fifty consecutive patients (44 men and 6 women who ranged in age from 35 to 71 years) were prospectively studied. Inclusion criteria were severe obstructive sleep apnea syndrome (respiratory disturbance index [RDI], >20/h in combination with typical clinical features), acceptance of nCPAP therapy, and agreement to the study protocol. Patients were randomly assigned to receive either automatically adjusting or conventional nCPAP. In order to avoid product-specific differences, such as design,
Results
Forty-eight of the 50 patients concluded the study; the two dropouts could not tolerate the treatment.
They both belonged to the group of patients treated with conventional nCPAP.
Age, sex, body mass index (BMI), and respiratory data at the initial adjustment were comparable between both groups (Table 1). In either group, no significant change of BMI took place in the course of the study (Table 2).
Both forms of treatment ameliorated sleep-disordered breathing. RDI, maximum and mean apnea
Discussion
Recently, self-adjusting nCPAP devices for the treatment of obstructive sleep apnea syndrome have been developed. Since the required mask pressure may vary depending on body position and sleep stage,4, 5, 12 self-adjusting nCPAP is supposed to change the pressure during the night and keep it as low as possible, whereas in conventional nCPAP treatment a mask pressure is required that constantly meets the maximum pressure needs of the patients and that is unchanged across the night.
Self-adjusting
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Treatment of Obstructive Sleep Apnea: Choosing the Best Positive Airway Pressure Device
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2010, Clinics in Chest MedicineThe value of auto-adjustable CPAP devices in pressure titration and treatment of patients with obstructive sleep apnea syndrome
2010, Sleep Medicine ReviewsCitation Excerpt :The acceptance of CPAP therapy, on the other hand, was similar or only slightly better after APAP titration, leading to a lower dropout rate in one study33 and a subjective preference of APAP over FPAP in others.11,15 Compliance data derived from APAP time-loggers over variable periods (2 weeks to 8 months), confirmed at most a tendency to higher APAP usage.11,16,19,21,22,27 Although a larger benefit in compliance was expected, previous research had already shown that pressure (in)tolerance was less important in this matter.