title: Nap-titration: an effective alternative for continuous positive airway pressure titration.
abstract: When treating Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) several alternatives for standard (manual) continuous positive airway pressure (CPAP) titration are feasible. A practical alternative is titration without polysomnography during an afternoon nap (Nap-titration). The aim of the present study was to assess whether Nap-titration is appropriate for effective titration of CPAP. Following Nap-titration 24 eligible OSAHS patients started conventional CPAP therapy. The outcome of Nap-titration was verified after 2 weeks with CPAP pressure adjustments being performed in case of persisting OSAHS symptomatology. Polysomnography and a questionnaire evaluation were performed at baseline and 8 weeks after Nap-titration. Following Nap-titration 15 patients did not require pressure changes while in 9 patients' CPAP pressure was raised due to persisting OSAHS symptomatology. Control polysomnography after 8 weeks showed successful CPAP titration (Apnea-Hypopnea Index <5) in 23 out of 24 patients. A pressure raise following polysomnography was indicated in 1 patient only. In addition, significant improvements were found in OSAHS symptomatology and quality of life. This study shows that in 96% of OSAHS patients' successful CPAP titration is attained following Nap-titration whether or not supplemented by pressure adjustments. Therefore, Nap-titration with an adequate follow-up appears an appropriate procedure for the effective titration of CPAP.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. a.hoekema@kchir.umcg.nl
authors.forename: Aarnoud
authors.initials: A
authors.lastname: Hoekema
authors.forename: Boudewijn
authors.initials: B
authors.lastname: Stegenga
authors.forename: Johannes G
authors.initials: JG
authors.lastname: van der Aa
authors.forename: Aafke F
authors.initials: AF
authors.lastname: Meinesz
authors.forename: Johannes H
authors.initials: JH
authors.lastname: van der Hoeven
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wijkstra
mesh_terms: D000328:Adult; D000465:Algorithms; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000295:instrumentation; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012895:Sleep, REM / Q000502:physiology*; D011795:Surveys and Questionnaires