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Am. J. Respir. Crit. Care Med., Volume 162, Number 1, July 2000, 94-97

Accuracy of an Unattended Home CPAP Titration in the Treatment of Obstructive Sleep Apnea

F. SÉRIÈS

Unité de Recherche, Centre de Pneumologie, Hôpital et Université Laval, Québec, Canada

Treatment of sleep apnea-hypopnea syndrome (SAHS) by fixed continuous positive airway pressure (CPAP) requires an in-laboratory titration procedure to determine the effective pressure level (Peff ). We recently reported that one auto-CPAP machine can be used without titration study allowing Peff determination. The aim of this study was to evaluate the accuracy of an auto CPAP trial at home. A 1- or 2-wk automatic CPAP trial was done at home in 40 patients by estimating the reference pressure (Pref ) to be set and a Pref + 3 cm H2O/-4 cm H2O pressure interval. Peff was then determined according to the percentage of CPAP time that was spent =< Pref. This Peff value was set on a fixed CPAP machine for two additional weeks and a control sleep study was done. The pressure setting on fixed CPAP had to be increased by 1 ± 1 cm H2O (mean ± SD) above estimated Pref. Sleep improved with fixed CPAP, with a normalization of the apnea + hypopnea index (AHI) in 38 of 40 and resumption of diurnal hypersomnolence. CPAP compliance remained excellent (CPAP use: 6.1 ± 1.7 h/ night) after 6.5 ± 2.8 mo of CPAP treatment. These results indicate that auto-CPAP therapy represents a new useful and accurate way to identify conventional CPAP setting outside hospital and sleep laboratories.




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