Daytime CPAP Titration

A Viable Alternative for Patients With Severe Obstructive Sleep Apnea

¹ From the Sleep Disorder and Research Center, Henry Ford Hospital, Detroit, MI.

Leon Rosenthal, MD, 2799 W Grand Boulevard, CFP-3, Detroit, MI 48202; e-mail: lronca{at}aol.com

Objective: Continuous positive airway pressure (CPAP) is the treatment of choice for patients diagnosed with severe obstructive sleep apnea (OSA). The implementation of CPAP therapy has traditionally been based on full-night titration studies or split-night protocols. This study compared a group of patients who received a regular nocturnal CPAP titration with patients who received a daytime CPAP titration. The objective of the study was to determine if daytime CPAP titration is a viable alternative for the implementation of CPAP treatment in patients with severe OSA.

Study design: Fourteen patients (13 men and one woman) received a daytime CPAP titration (day group). The day group was matched to 18 patients (17 men and one woman) who were titrated under a full-night regular nocturnal study (night group). Eligible patients were those with severe OSA (respiratory event index > 40). The groups were matched by age, sex, and body mass index.

Results: Daytime and nocturnal CPAP titration studies yielded sufficient amounts of rapid eye movement (REM) and non-REM sleep to help determine CPAP settings. Importantly, the diurnal and nocturnal CPAP titrations resulted in comparable therapeutic pressures as well as comparable resolution of sleep-disordered breathing. After 1 week of treatment, the groups exhibited similar CPAP use and comparable improvements in subjective sleepiness as indicated by their increase in sleep/wake activity inventory scores.

Conclusions: Daytime CPAP titration studies may be a viable alternative for the efficient and expedient implementation of CPAP therapy among some patients with severe OSA.

Key Words: acceptance • compliance • continuous positive airway pressure • excessive daytime sleepiness • obstructive sleep apnea • split-night protocol • treatment

Submitted on October 22, 1997
Accepted on March 24, 1998

This article has been cited by other articles:

				J.C. Rudkowski, P. Verschelden, and R.J. Kimoff Efficacy of daytime continuous positive airway pressure titration in severe obstructive sleep apnoea Eur. Respir. J., September 1, 2001; 18(3): 535 - 541. [Abstract] [Full Text] [PDF]

				Z. Oliver and V. Hoffstein Predicting Effective Continuous Positive Airway Pressure Chest, April 1, 2000; 117(4): 1061 - 1064. [Abstract] [Full Text] [PDF]