title: CPAP titration: Different methods for similar clinical results.
abstract: BACKGROUND
  Continuous positive airway pressure (CPAP) is the main treatment for obstructive sleep apnea-hypopnea syndrome (OSAHS). Polysomnography (PSG) is the gold standard for CPAP titration. However, alternative methods have been sought to titrate CPAP at less expense in terms of time and resources. The aim of this study was to analyze CPAP success in controlling OSAHS symptoms and adverse effects by two titration methods.
  
  
  METHODS
  This was a retrospective, observational cohort study in which 200 CPAP-naive patients who had been referred to our sleep laboratory and diagnosed with OSAHS were evaluated on two consecutive visits. During the first visit, an initial CPAP pressure was established either by split-night PSG or by using a mathematical formula. On the second visit, 1 month later, symptom persistence and adverse effects of CPAP treatment were assessed.
  
  
  RESULTS
  Patients included were 157 males (78.5%) and 43 females (21.5%) aged 56+/-10 years. 87 patients (43.5%) were titrated by PSG and 113 (56.5%) using the formula. At the second visit, symptoms had improved significantly for both groups with no significant differences in the presence of adverse effects. The initial pressure had to be readjusted in five patients.
  
  
  CONCLUSIONS
  This study suggests that formula titration can control symptoms as effectively as split-night titration. A prompt evaluation of the patient is advisable in order to ensure compliance with treatment and to correct possible adverse effects.
authors: Sección de Neumología y Alergia, Hospital Universitario Puerta del Mar, Avda. Ana de Viya, 21, E-11009 Cádiz, Spain.
authors: Jose Luis
authors: JL
authors: Lopez-Campos
authors: Cayo
authors: C
authors: Garcia Polo
authors: Antonio
authors: A
authors: Leon Jimenez
authors: Enrique
authors: E
authors: Gonzalez-Moya
authors: Aurelio
authors: A
authors: Arnedillo
authors: Juan Jose
authors: JJ
authors: Fernandez Berni