PURPOSE: To assess whether two commercially available flow generators that reduce pressure during expiration have equivalent impact on respiratory events and sleep quality in the treatment of obstructive sleep apnea (OSA).
METHODS: This was a prospective, randomized, single-blind, crossover, multi-center study of the S8 Elite Expiratory Pressure Relief (EPR) mode (ResMed) and the REMstar Pro C-Flex mode (Respironics). Among 88 adults, OSA-diagnosed patients screened for study eligibility, all experienced and compliant with continuous positive airway pressure (CPAP) in the C-Flex mode, 34 were eligible for participation. Titration studies utilizing C-Flex within the previous 12 months provided the baseline data. Subjects were randomized into two groups: one night on C-Flex mode followed by one night on EPR mode, or vice versa. After a desensitization period for subject acclimation to the EPR or C-Flex mode while awake, a polysomnography was conducted to obtain data on Apnea/Hypopnea Index, oxygen desaturation (percentage time below 90%), Arousal Index, and Sleep Efficiency. A visual analog scale was used to assess patient comfort.
RESULTS: There were no significant differences between the two reduced expiratory pressure modes across all study variables, though mask leak was significantly lower with the EPR mode.
CONCLUSION: EPR is clinically equivalent to C-Flex in a controlled sleep laboratory setting. Less mask leak may influence CPAP utilization level.
CLINICAL IMPLICATIONS: Expiratory Pressure Relief is a new technology that is comparable to the existing C-flex technology and may be helpful in improving compliance with nasal CPAP due to its ability to decrease mask leak.
DISCLOSURE: Lisa Wolfe, No Financial Disclosure Information; No Product/Research Disclosure Information