title: Efficacy and cost of home-initiated auto-nCPAP versus conventional nCPAP.
abstract: OBJECTIVE
  To compare in a multicenter prospective study the efficacy and cost of conventional nasal continuous positive airway pressure (nCPAP) initiated at the sleep laboratory versus auto-nCPAP initiated at home.
  
  
  METHODS
  Patients with severe obstructive sleep apnea syndrome (OSAS) were randomized to treatment with either the REM+ auto device in constant mode at the effective pressure determined by titration at the sleep laboratory (n=17) or the REM+ auto device in automatic mode initiated at the patients home by a nurse (n=18). After 2 months, the efficacy and cost of nCPAP therapy and the time from diagnosis to nCPAP were evaluated. All values are reported as means +/- SD.
  
  
  METHODS
  Thirty-five subjects with newly diagnosed OSAS (8 women and 27 men, mean age: 54.3 +/- 10.6 years, apnea-hypopnea index (AHI) 58.1 +/- 14.0 h(-1)).
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Both treatments were used properly and induced similar decreases in the AHI (7.6 +/- 6.9 vs. 10.4 +/ -12.5 h(-1) for auto-nCPAP and conventional nCPAP, respectively; NS) and Epworth Sleepiness score (from 15.5 +/- 4.7 to 7.5 +/- 3.4 vs. 14.7 +/- 3.9 to 7.6 +/- 3.4 for auto-nCPAP and conventional nCPAP, respectively; NS). With auto-nCPAP initiated at home, the time from diagnosis to final adjustment of nCPAP was shorter (16.3 +/- 5.0 vs. 47.2 +/- 46.5 days with conventional nCPAP, P < 0.02) and the cost was lower (1,263 +/- 352 vs. 1720+/-455 E, respectively; P < 0.05).
  
  
  CONCLUSIONS
  Treatment of OSAS with auto-nCPAP initiated at home is effective and reliable and reduces the time from diagnosis to therapy and the cost of treatment.
authors.affiliation: Service de Physiologie-Explorations Fonctionnelles, Hôpital Ambroise Paré, Assistance, Publique des Hôpitaux de Paris, Université Paris 5, 92100 Boulogne Billancourt, France. carole.planes@apr.ap-hop-paris.fr
authors.forename: Carole
authors.initials: C
authors.lastname: Planès
authors.forename: Marie-Pia
authors.initials: MP
authors.lastname: D'Ortho
authors.forename: Arlette
authors.initials: A
authors.lastname: Foucher
authors.forename: Malika
authors.initials: M
authors.lastname: Berkani
authors.forename: Karl
authors.initials: K
authors.lastname: Leroux
authors.forename: Mohamed
authors.initials: M
authors.lastname: Essalhi
authors.forename: Christophe
authors.initials: C
authors.lastname: Delclaux
authors.forename: Maria-Antonia
authors.initials: MA
authors.lastname: Quera-Salva
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lofaso
mesh_terms: D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000191:economics* / Q000295:instrumentation*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000191:economics* / Q000628:therapy*; D012895:Sleep, REM / Q000502:physiology