title: Auto bi-level pressure relief-PAP is as effective as CPAP in OSA patients--a pilot study.
abstract: OBJECTIVE
  Continuous positive airway pressure (CPAP) is the therapy of choice for the treatment of obstructive sleep apnea (OSA). Not all patients can use CPAP therapy with adequate compliance. There is a need to develop more comfortable modes. Auto bi-level Pressure Relief-Positive Airway Pressure (ABPR-PAP) can be an alternative. We conducted a prospective double-blind, randomised trial to evaluate the efficacy and compliance of ABPR-PAP compared with CPAP in OSA patients.
  
  
  METHODS
  We included 35 CPAP naive patients (age 53.3 ± 10.3 years, BMI 31.0 ± 5.0 kg/m(2), ESS 10.0 ± 4.2) diagnosed with moderate to severe OSA who underwent a successful CPAP titration. Patients were randomised into the CPAP or the ABPR-PAP treatment group. We used the same device (BIPAP® Auto, Philips Respironics) for CPAP or ABPR-PAP. Apnea-hypopnea index (AHI) was determined using polysomnography before (AHI 40.6 ± 18.3 per hour) and after treatment.
  
  
  RESULTS
  Eighteen patients received CPAP and the remaining 17 received APBR-PAP. Groups were similar in terms of demographics and OSA severity. There were no serious adverse events during the trial. CPAP was fixed by a sleep expert and ABPR-PAP varied (range 5-15 cmH(2)O). AHI decreased in the CPAP group to 6.4 ± 5.7 per hour and in the ABPR-PAP group to 4.8 ± 3.6 per hour in the first night (N = 35). After 3 months, the AHI decreased in the CPAP group to 4.4 ± 5.3 per hour and in the ABPR-PAP group to 2.6 ± 3.8 per hour (N = 32). Differences between the groups were not statistically significant. There were no differences in compliance.
  
  
  CONCLUSIONS
  ABPR-PAP is a promising new ventilation mode that enables effective treatment of OSA patients.
authors.affiliation: Charite-Universitätsmedizin Berlin, CCM, Internal Medicine, Cardiology and Angiology, Center of Sleep Medicine, Berlin, Germany. alexander.blau@charite.de
authors.forename: Alexander
authors.initials: A
authors.lastname: Blau
authors.forename: Mihaela
authors.initials: M
authors.lastname: Minx
authors.forename: Jan Giso
authors.initials: JG
authors.lastname: Peter
authors.forename: Martin
authors.initials: M
authors.lastname: Glos
authors.forename: Thomas
authors.initials: T
authors.lastname: Penzel
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Ingo
authors.initials: I
authors.lastname: Fietze
mesh_terms: D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D004311:Double-Blind Method; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D012894:Sleep Stages / Q000502:physiology; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods