A randomized trial of auto-titrating CPAP and fixed CPAP in the treatment of obstructive sleep apnea-hypopnea.
BACKGROUND
Continuous positive airway pressure (CPAP) remains the treatment of choice for obstructive sleep apnea hypopnea (OSAH). Auto-titrating CPAP (APAP) devices automatically adjust pressure and may improve treatment compliance compared to fixed CPAP (F-CPAP).


METHODS
Randomized, prospective, single-blind, crossover trial to compare efficacy, side effects, compliance, patient satisfaction and preference between APAP and F-CPAP therapy in patients with moderate to severe OSAH. There were two treatment periods of 4 weeks each (APAP and F-CPAP), separated by a 2-week washout period.


RESULTS
Ten CPAP-naive OSAH patients (9 males) completed the study. They had Mean +/- SD age of 44.9 +/- 9.7 years; body mass index of 35.9 +/- 12.9 kg/m2 and apnea/hypopnea index (AHI) of 47.2 +/- 35.6. Both forms of therapy were equally effective in improving the symptoms and in reducing the AHI. Both forms of therapy were associated with frequent side effects and had similar patient compliance. At the end of the study, more patients (6-1) preferred F-CPAP to A-CPAP therapy.


CONCLUSIONS
A-PAP was as effective as F-CPAP in the treatment of OSAH but was not associated with fewer side effects, better compliance, better satisfaction or increased patient preference.
Hussain
Syed F
SF
Section of Pulmonary Medicine, The Aga Khan University Hospital, Stadium Road, PO Box 3500, Karachi 74800, Pakistan. sfh_pulmonary@yahoo.co.uk
Love
Leslie
L
Burt
Heather
H
Fleetham
John A
JA
D000328:Adult; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017060:Patient Satisfaction; D017286:Polysomnography; D011446:Prospective Studies; D016037:Single-Blind Method; D020181:Sleep Apnea, Obstructive / Q000628:therapy*