| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
* From the Service de Physiologie-Explorations Fonctionnelles and Institut de la Santé et de la Recherche Médicale (INSERM) U492 (Drs. d’Ortho, Goldenberg, and Harf), Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil; Service d’Explorations Fonctionnelles (Dr. Lofaso), Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Garches; Département de Pneumologie-Laboratoire de Sommeil and UMR CNRS 5525 (Dr. Levy), CHU de Grenoble, Grenoble; Société Nellcor-Puritan Bennet (Dr. Grillier-Lanoir), Villers-lès-Nancy; and ADEP Assistance (Ms. Corriger), Rue Voltaire, Suresnes, France.
Correspondence to: Marie-Pia d’Ortho, MD, Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France; e-mail: dortho{at}im3.inserm.fr
Study objectives: To compare the efficacy and patient tolerance, compliance, and preference between auto-continuous positive airway pressure (CPAP) and constant CPAP.
Design: Single-blinded, crossover, cohort study of consecutive patients with obstructive sleep apnea syndrome, with two treatment periods of 2 months each.
Patients: Twenty-five patients (22 men, 3 women) with sleep apnea syndrome confirmed by ambulatory polysomnography.
Measurements and interventions: After baseline polysomnography, patients underwent in-laboratory polysomnography for titration of constant CPAP. The order of treatment was randomly allocated, either auto-CPAP and then constant CPAP, or vice versa. The auto-CPAP pressure range was 6 to 16 cm H2O. At the end of each 2-month period, patients underwent a control ambulatory polysomnography and received a questionnaire on subjective well-being and device evaluation. Duration of use was checked through CPAP device monitoring.
Results: No differences were found in apnea/hypopnea index (constant CPAP, 9.7 ± 1.9 events/h vs auto-CPAP, 10.6 ± 9.3 events/h), awakening/arousal index (constant CPAP, 13.7 ± 8.0 events/h vs auto-CPAP, 15.5 ± 8.9 events/h), slow-wave sleep duration, nocturnal saturation, or complaint of daytime sleepiness. The mean pressure required was significantly lower during auto-CPAP than during constant CPAP (8.8 ± 1.8 cm H2O vs 9.7 ± 2.6 cm H2O, respectively). Patient tolerance, compliance, and duration of use were similar with both treatments.
Conclusions: Auto-CPAP is as effective as constant CPAP. A wide pressure range for auto-CPAP can be used in all patients, suggesting that, in the future, use of a broad pressure range in the auto-CPAP mode could obviate the need for the titration night.
Key Words: continuous positive airway pressure titration • obstructive sleep apnea
This article has been cited by other articles:
|
|
 |
|
  G. Nilius, A. Happel, U. Domanski, and K.-H. Ruhle Pressure-Relief Continuous Positive Airway Pressure vs Constant Continuous Positive Airway Pressure: A Comparison of Efficacy and Compliance. Chest, October 1, 2006; 130(4): 1018 - 1024. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Rigau, J. M. Montserrat, H. Wohrle, D. Plattner, M. Schwaibold, D. Navajas, and R. Farre Bench model to simulate upper airway obstruction for analyzing automatic continuous positive airway pressure devices. Chest, August 1, 2006; 130(2): 350 - 361. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. M. Nolan, S. Ryan, T. M. O'Connor, and W. T. McNicholas Comparison of three auto-adjusting positive pressure devices in patients with sleep apnoea Eur. Respir. J., July 1, 2006; 28(1): 159 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Abdenbi, B. Chambille, and P. Escourrou Bench testing of auto-adjusting positive airway pressure devices Eur. Respir. J., October 1, 2004; 24(4): 649 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Noseda, C. Kempenaers, M. Kerkhofs, S. Braun, P. Linkowski, and E. Jann Constant vs Auto-Continuous Positive Airway Pressure in Patients With Sleep Apnea Hypopnea Syndrome and a High Variability in Pressure Requirement Chest, July 1, 2004; 126(1): 31 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Fitzpatrick, C. E. D. Alloway, T. M. Wakeford, A. W. MacLean, P. W. Munt, and A. G. Day Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure? Am. J. Respir. Crit. Care Med., March 1, 2003; 167(5): 716 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. W. Flemons Obstructive Sleep Apnea N. Engl. J. Med., August 15, 2002; 347(7): 498 - 504. [Full Text] [PDF]
|
|
|
|
|
|
R. Farre, J. M. Montserrat, J. Rigau, X. Trepat, P. Pinto, and D. Navajas Response of Automatic Continuous Positive Airway Pressure Devices to Different Sleep Breathing Patterns: A Bench Study Am. J. Respir. Crit. Care Med., August 15, 2002; 166(4): 469 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Marrone, G. Insalaco, M. R. Bonsignore, S. Romano, A. Salvaggio, and G. Bonsignore Sleep Structure Correlates of Continuous Positive Airway Pressure Variations During Application of an Autotitrating Continuous Positive Airway Pressure Machine in Patients With Obstructive Sleep Apnea Syndrome Chest, March 1, 2002; 121(3): 759 - 767. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Lévy and J.-L. Pépin Autoadjusting Continuous Positive Airway Pressure . What Can We Expect? Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1295 - 1296. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
