Constant continuous positive airway pressure (CPAP) is the treatment of choice for the obstructive sleep apnea syndrome (OSAS). To enable the pressure to be matched more accurately to actual requirements, and thus increase patient acceptance, an autoadjusting device based on the measurement of upper airway impedance was developed (APAP(FOT)). We investigated the efficacy and compliance in continuous use at home. Fifty-two patients were treated (randomized crossover) with CPAP and APAP(FOT) for 6 wk each. Respiratory disturbances, sleep profile, and arousals improved significantly with both modes (AHI: baseline, 35.1 +/- 26/h; APAP(FOT), 5.0 +/- 5.2; CPAP, 4.3 +/- 6.3; p < 0.001 baseline versus each mode). The mean pressure with APAP(FOT) was significantly reduced as compared with CPAP (CPAP, 7.8 +/- 1.5 cm H2O; APAP(FOT), 5.7 +/- 1.8 cm H2O; p < 0.001). Under APAP(FOT) the pressure was lower than that under CPAP for 81.5 +/- 21% of the time. Although overall use did not differ, 75% of the patients preferred APAP(FOT) for home treatment. We conclude that APAP(FOT) is as efficacious as constant CPAP in the treatment of OSAS. The treatment pressure can be reduced significantly, and sleep microstructure improved with APAP(FOT). These might be the reasons for patient preference of automatic therapy.
Although tongue-muscle training cannot generally be recommended for the treatment of sleep apnea, the method has proven to be effective in the treatment of snoring.
This is an English translation of the published German pocket guideline "S3-Leitlinie Nicht erholsamer Schlaf/Schlafstörungen-Kapitel Schlafbezogene Atmungsstörungen bei Erwachsenen-Kurzversion" Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) 2017. A complete list of references can be found in the original publication of the S3 guideline:
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