title: Comparison of manual versus automatic continuous positive airway pressure titration and the development of a predictive equation for therapeutic continuous positive airway pressure in Chinese patients with obstructive sleep apnoea.
abstract: OBJECTIVE
  Whether the therapeutic nasal continuous positive airway pressure (CPAP) derived from manual titration is the same as derived from automatic titration is controversial. The purpose of this study was to compare the therapeutic pressure derived from manual titration with automatic titration.
  
  
  METHODS
  Fifty-one patients with obstructive sleep apnoea (OSA) (mean apnoea/hypopnoea index (AHI) = 50.6 ± 18.6 events/h) who were newly diagnosed after an overnight full polysomnography and who were willing to accept CPAP as a long-term treatment were recruited for the study. Manual titration during full polysomnography monitoring and unattended automatic titration with an automatic CPAP device (REMstar Auto) were performed. A separate cohort study of one hundred patients with OSA (AHI = 54.3 ± 18.9 events/h) was also performed by observing the efficacy of CPAP derived from manual titration.
  
  
  RESULTS
  The treatment pressure derived from automatic titration (9.8 ± 2.2 cmH(2)O) was significantly higher than that derived from manual titration (7.3 ± 1.5 cmH(2)O; P < 0.001) in 51 patients. The cohort study of 100 patients showed that AHI was satisfactorily decreased after CPAP treatment using a pressure derived from manual titration (54.3 ± 18.9 events/h before treatment and 3.3 ± 1.7 events/h after treatment; P < 0.001).
  
  
  CONCLUSIONS
  The results suggest that automatic titration pressure derived from REMstar Auto is usually higher than the pressure derived from manual titration.
authors.affiliation: Sleep Center, State Key Laboratory of Respiratory Disease, Guangzhou Medical College, Guangzhou, China.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Luo
authors.forename: Sichang
authors.initials: S
authors.lastname: Xiao
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Qiu
authors.forename: Ning
authors.initials: N
authors.lastname: Song
authors.forename: Yuanming
authors.initials: Y
authors.lastname: Luo
mesh_terms: D001331:Automation / Q000379:methods*; D002681:China / Q000453:epidemiology; D045422:Continuous Positive Airway Pressure / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods*; D015995:Prevalence; D015203:Reproducibility of Results; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D017186:Titrimetry / Q000379:methods; D016896:Treatment Outcome