[Efficacy of demand of positive airway pressure therapy for treating obstructive sleep apnea syndrome].
The treatment of choice for obstructive sleep apnea syndrome (OSAS) is nasal continuous positive airway pressure (nCPAP). The precise level of pressure is adjusted by polysomnography. Devices to deliver pressure on demand have recently been designed to adapt the level of pressure to each respiratory cycle according to flow modification.


OBJECTIVE
To compare the manual titering nCPAP system with that of demand continuous positive airway pressure (nDPAP) in patients diagnosed of OSAS.


METHODS
Eighteen consecutive patients whose OSAS was diagnosed by conventional polysomnography were enrolled with apnea-hypopnea indexes over 10/hour (AHI > 10) and clinical symptoms of daytime drowsiness and/or cardiovascular risk factors. Titering polysomnographs were performed for all patients with nCPAP and with nDPAP and analyzed blindly.


RESULTS
No significant differences between nCPAP and nDPAP were found in neurophysiological variables analyzed (sleep architecture, arousals, sleep efficiency) or in respiratory variables (AHI, oxygen saturation) with the exception of minimum SatO2 during REM sleep, which was significantly better with nCPAP (p < 0.03). Mean end pressure with nCPAP and mean pressure with nDPAP were similar; it is also worth noting that mean pressure was lower with nDPAP than with titered nCPAP pressure a mean 65.7 +/- 22% of the time.


CONCLUSIONS
Automatic nDPAP is as effective as titered nCPAP for treating patients with OSAS.
García Arroyo
I
I
Unidad de Trastornos Respiratorios del Sueño, Hospital General Yagüe, Burgos.
Terán Santos
J
J
Cordero Guevara
J
J
Rodríguez Pascual
L
L
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods; D012891:Sleep Apnea Syndromes / Q000628:therapy*
Eficacia de la presión positiva a demanda en el tratamiento del síndrome de apnea obstructiva del sueño.