Constant vs. automatic continuous positive airway pressure therapy: home evaluation.
OBJECTIVE
To compare the efficacy and patient tolerance, compliance, and preference between auto-continuous positive airway pressure (CPAP) and constant CPAP.


METHODS
Single-blinded, crossover, cohort study of consecutive patients with obstructive sleep apnea syndrome, with two treatment periods of 2 months each.


METHODS
Twenty-five patients (22 men, 3 women) with sleep apnea syndrome confirmed by ambulatory polysomnography.


METHODS
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 H(2)O. 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 H(2)O vs. 9.7+/-2.6 cm H(2)O, 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.
d'Ortho
M P
MP
Service de Physiologie-Explorations Fonctionnelles and Institut de la Santé et de la Recherche Médicale (INSERM) U492, Hôpital Henri Mondor, Assistance Publique-H opitaux de Paris, Créteil.
Grillier-Lanoir
V
V
Levy
P
P
Goldenberg
F
F
Corriger
E
E
Harf
A
A
Lofaso
F
F
D002940:Circadian Rhythm / Q000502:physiology; D018592:Cross-Over Studies; D005260:Female; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods*; D016037:Single-Blind Method; D012890:Sleep / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome