title: Oscillating Positive Airway Pressure Versus CPAP for the Treatment of Obstructive Sleep Apnea.
abstract: Although continuous positive airway pressure (CPAP) is the most effective therapy for obstructive sleep apnea (OSA), it is not always well tolerated by the patients. Previous physiological studies showed that pressure oscillations applied to the pharynx could activate upper airway muscles, but it is not clear whether these pressure oscillations could be tolerated during sleep in OSA patients. The aim of this study was to assess the tolerance of oscillating positive airway pressure (O-PAP) (a CPAP device delivering high-frequency pressure oscillations to the upper airway) compared to CPAP. Fourteen OSA patients currently on CPAP [age 59.9 ± 10.1 years old, BMI 34.8 ± 7.2 kg/m(2), initial apnea-hypopnea index (AHI): 58.7 ± 25.2 events/h] used O-PAP or CPAP on two consecutive nights under polysomnography, in a single-blind randomized crossover design to assess sleep quality. A subtherapeutic pressure (70% of the optimal titrated pressure) was applied in both conditions and the residual AHI with each technique was also compared. There was no difference in measured or perceived sleep quality between the two treatment modalities (sleep efficiency 90.0% versus 88.1%, p = 0.54). Despite the small sample, we also found a trend toward a decrease in residual respiratory events with O-PAP compared to CPAP (median AHI 14.3 versus 20.5/h, p = 0.194). The good tolerance of O-PAP and the positive trend toward a reduction in residual AHI should stimulate further research on the effects of O-PAP in OSA patients.
authors.affiliation: Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV) , Lausanne , Switzerland.
authors.forename: José
authors.initials: J
authors.lastname: Haba-Rubio
authors.affiliation: Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV) , Lausanne , Switzerland.
authors.forename: Nicolas Julien
authors.initials: NJ
authors.lastname: Petitpierre
authors.affiliation: Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV) , Lausanne , Switzerland.
authors.forename: Françoise
authors.initials: F
authors.lastname: Cornette
authors.affiliation: Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV) , Lausanne , Switzerland.
authors.forename: Nadia
authors.initials: N
authors.lastname: Tobback
authors.affiliation: Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV) , Lausanne , Switzerland.
authors.forename: Sopharat
authors.initials: S
authors.lastname: Vat
authors.affiliation: Laboratory of Hemodynamics and Cardiovascular Technology, Swiss Federal Institute of Technology , Lausanne , Switzerland.
authors.forename: Theresia
authors.initials: T
authors.lastname: Giallourou
authors.affiliation: Institute of Biomedical Technologies, Auckland University of Technology , Auckland , New Zealand.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Jumaily
authors.affiliation: Center for Investigation and Research in Sleep, University Hospital of Lausanne (CHUV) , Lausanne , Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Heinzer
keywords: arousal; continuous positive airway pressure; obstructive sleep apnea; pharynx; vibration