CPAP with algorithm-based versus titrated pressure: A randomized study.
BACKGROUND
Our goal was to evaluate whether an algorithm-prescribed pressure is effective in sleep apnea-hypopnea syndrome (SAHS) patients requiring continuous positive airway pressure (CPAP).


METHODS
SAHS patients with an apnea-hypopnea index (AHI)>20/h were selected for a parallel group randomized study including an in-sleep laboratory acute phase and a domiciliary chronic phase. After baseline polysomnography, patients had a second night polysomnography either with CPAP at the algorithm-calculated pressure, followed by home treatment at this pressure without any correction or adjustment (calculation group), or with auto-CPAP titration, followed by home treatment at the pressure judged to be optimal from the auto-titration (titration group). The primary outcome was the change in Epworth sleepiness scale (ESS) at 6 months.


RESULTS
The calculated pressure (mean (SD)) was 7.0 (1.4) in the calculation group (n=33), while the optimal pressure was 7.0 (2.2)cmH(2)O in the titration group (n=36). During the 6-month treatment at home, the ESS decreased from 8.3 (4.9) to 5.4 (4.0) in the calculation group (n=20) and from 8.7 (5.4) to 6.4 (5.4) in the titration group (n=20) (between-group difference not significant).


CONCLUSIONS
In these SAHS patients with moderate sleepiness treated with CPAP, we found no difference in effectiveness between an algorithm-based pressure and an auto-titrated pressure.
Noseda
A
A
CHU Brugmann, Brussels, Belgium. andre.noseda@chu-brugmann.be
André
S
S
Potmans
V
V
Kentos
M
M
de Maertelaer
V
V
Hoffmann
G
G
D000328:Adult; D000368:Aged; D000403:Airway Resistance; D000465:Algorithms; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012648:Self Care; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D016896:Treatment Outcome