PURPOSE: Comparison of Home Auto Adjust Positive Airway Pressure Titration with Inpatient Sleep Lab Titration.
METHODS: 25 adults were studied with a diagnosis of obstructive sleep apnea as determined by baseline polysomnography (PSG). Clinical ideal CPAP pressure was determined based on RDI, O2 saturation, snoring, and pressure flow tracing. Subjects underwent an APAP study at home with a minimum requirement of 7 days usage and an average usage of 5 hours per night. One manufacturer of APAP devices (Respironics) was used. Subjects with an RDI on ideal clinical CPAP treatment level of <10 events per hour with the oxygen saturation remaining at 88% or higher during CPAP titration were included. Other parameters were examined: mean pressure, AHI, # days used/studied and mask leak. Scores from Epworth Sleepiness Scale (ESS) and SleepMed Insomnia Index (SMI) were collected at each office visit.
RESULTS: Means with standard deviations are discussed. BMI was 33(8). For the baseline PSG RDI was 19(11), nadir oxygen saturation was 80(7), ODI @3% was 15(8) and ODI @4% was 10(6). For the CPAP titration data on the measured level, RDI was 2(2), nadir oxygen saturation was 91(2), # minutes REM/supine was 13(17), # minutes on ideal CPAP level was 192(107)and # minutes of snoring was 7(20). Means for APAP were as follows: 19(12) days used with a total of 20(12)days studied, #hours used 7(1), AHI 2(1), pressure at the 90 percentile 9(1), mean pressure 7(1), average leak 32(6)LPM, and leak at 90% 40(11)LPM. Independent t-tests comparing the clinical CPAP with APAP at the 90% were significant at p<0.05. ESS and SMI scores demonstrated improvement following treatment. The ESS pre-PSG was 12(5) and SMI 20(10). Post CPAP therapy, the ESS was 8(5) and SMI 15(9).
CONCLUSION: Ideal CPAP pressures as determined by clinical PSG measures differed from APAP levels by 1 cm.
CLINICAL IMPLICATIONS: APAP correlates with clinical CPAP titration in patients symptomatic with mild to moderate obstructive sleep apnea.
DISCLOSURE: Richard Bogan, None.