Continuous positive airway pressure titration for obstructive sleep apnoea: automatic versus manual titration

Thorax
N McArdleDavid R Hillman

Abstract

Manual laboratory continuous positive airway pressure (CPAP) titration for obstructive sleep apnoea (OSA) is costly, time intensive and delays access to treatment. Automatic positive airway pressure (APAP) titration has the potential to reduce cost and improve access to treatment. The aim of this study was to assess the clinical efficacy and costs of APAP titration compared with manual titration in moderate-severe OSA. Patients with moderate-severe OSA (apnoea/hypopnoea index >15 and Epworth Sleepiness Score > or = 8) who were free of co-morbidities that could impair APAP titration were eligible. 249 participants were randomised to manual titration, home APAP or laboratory APAP titration to determine a fixed pressure for CPAP. Clinical and direct cost outcomes were assessed after 4 weeks of treatment. Average nightly CPAP use, subjective sleepiness, SF36 quality of life, Trails A and B cognitive function and polysomnographic outcomes were similar among the per-protocol groups. Non-hypertensive patients had a lower resting heart rate (and greater reduction in heart rate) at 4 weeks after laboratory APAP titration compared with home APAP titration. Costs per patient were highest in manual (AU$817.84), followed by laboratory (AU$6...Continue Reading

Associated Clinical Trials

Citations

Feb 25, 2011·Sleep & Breathing = Schlaf & Atmung·Weijie GaoYuan Deng
Jun 4, 2013·Sleep Medicine Reviews·Megan R CrawfordRon R Grunstein
Jul 26, 2014·Archivos de bronconeumología·Nicolás González MangadoTeresa Gómez García
Jul 26, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Devin L BrownLewis B Morgenstern
Feb 26, 2013·Respirology : Official Journal of the Asian Pacific Society of Respirology·Ching Li Chai-CoetzerR Doug McEvoy
Jul 6, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Marcello BosiGiulio Alessandri-Bonetti
Jul 6, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Eugenio De CorsoEmanuele Scarano
Mar 21, 2020·Sleep & Breathing = Schlaf & Atmung·Sezgi Şahin DuyarDeniz Çelik
Mar 11, 2020·Multidisciplinary Respiratory Medicine·Hang Dinh-Thi-DieuSy Duong-Quy

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