Auto-CPAP Therapy for Obstructive Sleep Apnea: Induction of Microarousals by Automatic Variations of CPAP Pressure?

Insomnia as an expression of obstructive sleep apnea syndrome – the effect of treatment with nocturnal ventilatory support

“…Previous studies have suggested that pressure variation during the night could be the reason for sleep fragmentation, and, as a consequence, insomnia complaints in patients undergoing APAP. 17,18 During our study, all patients that kept insomnia after beginning NVS were under APAP, except one patient with BPAP. Another possibility would be the presence of exclusion diagnostics, harder to identify, such as idiopathic insomnia, paradoxical insomnia, or even changes in the circadian rhythm.…”

Bench testing of auto-adjusting positive airway pressure devices

“…The AutoSet1T and the SomnoSmart1 increased the pressure rapidly, which is not recommended in sleeping patients because of potential arousals [35].…”

Fixed-pressure CPAP versus auto-adjusting CPAP: comparison of efficacy on blood pressure in obstructive sleep apnoea, a randomised clinical trial

“…Any disturbance in sleep quality is a mechanism through which an increase in sympathetic tone and in turn elevated BP can appear. The manner in which AutoCPAP functions is associated with a more unstable upper airway that can sometimes induce micro-arousals 24 25. Also, inappropriate increases in pressure can occur even in normal subjects after a change in body position, after a central apnoea, during a period of flow limitation or, most frequently, without any identifiable reason 45.…”

“…Theoretically, when using AutoCPAP for long-term treatment, varying the pressure delivered would improve patient comfort and thus enhance compliance. However, the variations in pressure associated with the functioning of AutoCPAP devices may induce micro-arousals and potentially change sleep macrostructure in some patients 24 25. This could lead to greater sympathetic activity that counters BP reduction in response to CPAP treatment.…”