Auto bi-level with pressure relief during exhalation as a rescue therapy for optimally treated obstructive sleep apnoea patients with poor compliance to continuous positive airways pressure therapy—a pilot study

Abstract

Auto bi-level with pressure relief during exhalation treats OSA as effectively as CPAP without inducing additional arousals. Transitioning non-compliant CPAP patients without modifiable causes of poor compliance from their CPAP to this new device improves compliance and clinical outcomes over a 10-week period.

Efficacy of Bilevel-auto Treatment in Patients with Obstructive Sleep Apnea Not Responsive to or Intolerant of Continuous Positive Airway Pressure Ventilation

“…7 However, in patients requiring an effective CPAP level higher than 10 cm H 2 O there was a greater significant improvement in mean usage/night. In a randomized controlled trial, Ballard et al found that, changing to flexible bilevel airway pres sure therapy improved compliance in patients previously not compliant with CPAP therapy.…”

“…Bilevel-auto was proposed as an alternative to CPAP as a rescue therapy in the presence of poor compliance or tolerance. 7,[11][12][13] A validation study performed in OSAS patients naïve to CPAP treatment, compared the efficacy of Bilevel-auto against standard CPAP and subjective and objective compliance over 90 days of use. 6 Authors did not find statistically significant differences in efficacy or compliance between the two treatments, raising the question of whether Bilevel-auto could be considered as an alternative therapy in patients not tolerating CPAP.…”

“…Bilevel-auto delivers spontaneous bilevel therapy, automatically adjusting expiratory (EPAP) and inspiratory (IPAP) levels to meet the patient's needs (see below). 6,7 This new therapy was found to be equally effective as standard CPAP therapy, and adherence to the two therapies was comparable. 6 Indeed, in patients who did not tolerate CPAP, this therapy seemed to be associated with better adherence to the treatment.…”

“…6 Indeed, in patients who did not tolerate CPAP, this therapy seemed to be associated with better adherence to the treatment. 7 In our experience there is another group of patients who may benefi t from the use of this new mode of ventilation: patients whose nocturnal episodes of apnea-hypopnea are not completely …”

Sleep Apnea – Recent Updates

“…These have included auto-bi-level pressure relief-positive airway pressure (ABPR-PAP). Four studies [64][65][66][67] showed similar improvements in symptoms using an auto-bi-level mode and CPAP. Compliance was generally beter with the auto-bi-level modes than CPAP, even in CPAP patients selected for poor compliance [65,67].…”