AutoSet nasal CPAP titration: constancy of pressure, compliance and effectiveness at 8 month follow-up

Abstract

We have previously shown that AutoSet satisfactorily improves sleepdisordered breathing and sleep architecture in subjects with obstructive sleep apnoea (OSA) syndrome. The aim of this study was to determine, in subjects treated with long-term conventional fixed pressure continuous positive airway pressure (CPAP) at the AutoSet recommended pressure, whether: the long-term compliance is satisfactory; the improvement persists once initial rebound is over; the titration pressure is stable with time; and the titration pressure is comparable with manual titration pressure using a similar end-point.Twenty males with OSA, previously studied with full polysomnography on their diagnostic night, at manual and AutoSet titration, and at the AutoSet recommended fixed pressure, were re-studied after a mean of 3 and 8 months of treatment at the recommended fixed pressure. Re-study included home respiratory monitoring (Nellcor EdenTrace™), and repeated manual and AutoSet titration with polysomnography. Compliance was assessed with hour-meter readings.Mean ( In conclusion, the AutoSet recommended pressure varies little with time, and closely predicts the final manual titration pressure; the improvement in respiratory disturbance index was largely maintained, and compliance was good, although probably enhanced by close supervision.

Auto-adjusting positive airway pressure in children with sickle cell anemia: results of a phase I randomized controlled trial

“…10 The introduction of auto-adjusting CPAP (auto-CPAP), in addition to advances in interfaces, improves tolerance and has fewer side effects. 11 Oxygen supplementation may also be a useful addition to auto-CPAP to reverse low nocturnal SpO2, but a previous study showed oxygen therapy can lead to bone marrow suppression and rebound pain. 12 These adverse effects might not occur if oxygen supplementation is titrated against nocturnal SpO2 levels as an adjunct to auto-CPAP treatment.…”

Efficacy of daytime continuous positive airway pressure titration in severe obstructive sleep apnoea

“…While this approach offers many advantages, it is time-consuming and expensive. A variety of alternative approaches have been described including: split-night diagnostic/titration studies [2][3][4][5][6], laboratory titration using automated nCPAP devices [7][8][9][10], home attended manual or unattended automated titration [11][12][13], and empiric treatment using prediction formulae [14]. Studies to date have indicated that there are potential advantages, but also limitations, to each of these approaches; and considerable work is required to establish the shortand long-term therapeutic efficacy of these alternate methods.…”

Obstructive sleep apnea syndrome - therapy

“…Im Unterschied zu den konventionellen CPAP-Systemen werden bei der autotitrierenden PAP-Therapie kontinuierlich entweder pneumotachographisch eine Drucklimitation oder oszillometrisch eine Änderung des Widerstandes der oberen Atemwege erfasst und konsekutiv eine automatische Druckanpassung vorgenommen (11,18). Dies bedeutet, dass sich der maschinell applizierte Druck während der gesamten Nacht ändern kann und intraindividuell auch von Tag zu Tag -je nach Körperposition, Schlafstadien oder anderen prädisponierenden Faktoren -unterschiedliche Druckverläufe dokumentiert werden können.…”