title: Study of a Novel APAP Algorithm for the Treatment of Obstructive Sleep Apnea in Women.
abstract: OBJECTIVE
  To assess the efficacy of a novel female-specific autotitrating continuous positive airway pressure (CPAP) algorithm (AutoSet for her, AfH) in premenopausal women relative to a standard autotitrating algorithm (AutoSet, S9) (ResMed Ltd., Bella Vista, New South Wales, Australia).
  
  
  METHODS
  Prospective randomised crossover noninferiority trial.
  
  
  METHODS
  Tertiary hospital sleep clinic and university research sleep laboratory.
  
  
  METHODS
  20 female patients with obstructive sleep apnea (OSA) established on long-term CPAP treatment.
  
  
  METHODS
  Treatment with 1 night each of AfH and AutoSet while monitored with overnight laboratory-based polysomnography (PSG); order randomly allocated.
  
  
  RESULTS
  The primary outcome variables were the apnea-hypopnea index (AHI) and 3% oxygen desaturation index (ODI 3%) determined from PSG. Treatment efficacy on the AfH night was noninferior to the AutoSet night as assessed by median (IQR) AHI (1.2 [0.60-1.85]/h versus 1.15 [0.40-2.85]/h, respectively, P = 0.51) and 3% ODI (0.85 [0.25-1.5]/h versus 0.5 [0.25-2.55]/h, respectively, P = 0.83). Other PSG measures were similar, except for the percentage of the night spent in flow limitation, which was lower on the AfH (0.14%) than the AutoSet night (0.19%, P = 0.007). The device-downloaded 95th centile pressure on the AfH night was also lower than on the AutoSet night (10.6 ± 1.7 versus 11.6 ± 2.6 cmH2O, respectively; mean difference [95% confidence interval]: -1.1 [-2.13 to -0.01] cm H2O).
  
  
  CONCLUSIONS
  Among premenopausal women a novel female-specific autotitrating algorithm (AfH) is as effective as the standard AutoSet algorithm in controlling obstructive sleep apnea (OSA). The new algorithm may reduce flow limitation more than the standard algorithm and achieve control of OSA at a lower (95th centile) pressure.
authors.affiliation: School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.|West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: McArdle
authors.affiliation: School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.|West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: King
authors.affiliation: School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.|West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Shepherd
authors.affiliation: School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.|West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Baker
authors.affiliation: ResMed Science Centre, Bella Vista, Sydney, Australia.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Ramanan
authors.affiliation: ResMed Science Centre, Bella Vista, Sydney, Australia.
authors.forename: Sahisha
authors.initials: S
authors.lastname: Ketheeswaran
authors.affiliation: ResMed Science Centre, Bella Vista, Sydney, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Bateman
authors.affiliation: ResMed Science Centre, Bella Vista, Sydney, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Wimms
authors.affiliation: ResMed Science Centre, Bella Vista, Sydney, Australia.
authors.forename: Jeff
authors.initials: J
authors.lastname: Armitstead
authors.affiliation: ResMed Science Centre, Bella Vista, Sydney, Australia.
authors.forename: Glenn
authors.initials: G
authors.lastname: Richards
authors.affiliation: School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.|West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Hillman
authors.affiliation: School of Anatomy, Physiology and Human Biology, University of Western Australia, Nedlands, Australia.|West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Eastwood
mesh_terms: D000328:Adult; D000465:Algorithms; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D009517:New South Wales; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography; D017697:Premenopause; D011312:Pressure; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D010100:Oxygen
keywords: apnea-hypopnea index; automatic positive airway pressure algorithm; continuous positive airway pressure; obstructive sleep apnea; positive airway pressure titration; premenopausal women