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Comparison of manual versus automatic continuous positive airway pressure titration and the development of a predictive equation for therapeutic continuous positive airway pressure in C hinese patients with obstructive sleep apnoea
Author(s) -
Luo Jiaying,
Xiao Sichang,
Qiu Zhihui,
Song Ning,
Luo Yuanming
Publication year - 2013
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12014
Subject(s) - continuous positive airway pressure , medicine , titration , polysomnography , anesthesia , airway , surgery , obstructive sleep apnea , apnea , chemistry , inorganic chemistry
Background and 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 ( REM star 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 cm H 2 O ) was significantly higher than that derived from manual titration (7.3 ± 1.5 cm H 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 REM star Auto is usually higher than the pressure derived from manual titration.