PURPOSE: To determine if races can be used to help predict the titrated Continuous Positive Airway Pressure (CPAP) (in cm H2O) among the adult Singapore population.
METHODS: A retrospectuve analysis of polysomnographic data from attended, full-night or split titration studies carried out at the sleep disorders unit of a tertiary hospital in Singapore.
RESULTS: 1106 polysomnographic studies were performed in Singapore General Hospital in 2007, 203 patients (age: 21–90 years) underwent a titration study (either full titration study or split-night study) to determine the optimal pressure needed to abolish sleep disordered breathing (SDB). 158 patients (121 males, 37 females) went through manual CPAP titration. There were 131 (69%) Chinese, 18 (9.5%), 29 (15.3%) Indians and 11 (5.8%) Others. Mean titrated pressure was 9.05 cmH2O for Chinese, 9.17cmH2O for Malays, 9.59 cmH2O for Indians and 8.13 cmH2O for other races. There was no statistical difference in titrated pressures after adjusting for BMI, neck circumference, gender and apnoea-hypopnea index (AHI). Overall, the best predictor of CPAP pressures required was the AHI, which showed a correlation factor of B = 0.0405 (p < 0.0005). Nadir O2 also showed a trend towards negative correlation with pressure (B= -0.046, p= 0.055). The mean pressure titrated for the 158 patients was 9.07. The mean pressure required by the 121 males was 9.12, compared to a lower female mean pressure of 8.92. The Indian females require the highest mean pressure of 11.67 compared to all of the males and females from other races. The Malay males requires the highest mean pressure of 9.89 in comparison to the males from the other three races.
CONCLUSION: Despite data showing racial differences in the clinical presentation of obstructive sleep apnoea, race is not a determinant of the titrated CPAP pressure needed to abolish sleep disordered breathing among our patients.
CLINICAL IMPLICATIONS: Race cannot be used to predict CPAP pressures.
DISCLOSURE: Shakina Abdul Rahim, None.