Computerized adjustable versus fixed NCPAP treatment of obstructive sleep apnea

• Published in: Sleep (New York, N.Y.) Vol. 19; no. 6; pp. 491 - 496
• Main Authors: SCHARF, M. B, BRANNEN, D. E, MCDANNOLD, M. D, BERKOWITZ, D. V
• Format: Journal Article
• Language: English
• Published: Rochester, MN American Academy of Sleep Medicine 01.07.1996
• Subjects: Adult; Analysis of Variance; Biological and medical sciences; Diseases of the upper aerodigestive tract; Ent and stomatology; Female; Humans; Male; Medical sciences; Middle Aged; Positive-Pressure Respiration - instrumentation; Pulmonary Ventilation - physiology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sleep Apnea Syndromes - physiopathology; Sleep Apnea Syndromes - therapy; Human; Sleep apnea syndrome; Methodology; Upper respiratory tract; Self evaluation; Treatment efficiency; Sleep disorder; Obstruction; Positive pressure; Automatic system; ENT disease; Mechanical ventilation; Comparative study
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/19.6.491

An automated positive airway pressure device that monitors respiratory patterns and provides dynamic, real-time, relational pressure has been developed for the treatment of obstructive sleep apnea (OSA). The purpose of this study was to compare self-adjusting pressure to classical nasal continuous positive airway pressure (NCPAP). Subjects were newly diagnosed patients with a minimum respiratory disturbance index (RDI) of 15 episodes per hour who had undergone NCPAP titration and been using classical NCPAP at home on a nightly basis for at least 2 weeks. Patients then underwent repeat standard polysomnographic (PSG) evaluations for 2 nights using a self-adjusting pressure mode and a standard NCPAP mode randomly assigned in a single-blind crossover fashion. Eight males and four females (n = 12), aged 48.4 +/- 12.2 years [mean +/- and standard deviation (SD)], completed the study. During initial diagnostic PSG, the RDI was 57.3 +/- 30.8 episodes per hour. The RDI and minimum oxygen saturation for both treatment nights were significantly improved from those of the diagnostic PSGs (p < 0.001). The subjects spent 63.1 +/- 34.2% of total sleep time below prescribed pressure while on automatic pressure Percent of total sleep time in stage 3/4 sleep was significantly higher during self-adjusting pressure, at 8.6 +/- 7.5%, compared to standard NCPAP, at 4.6 +/- 6.0% (p < 0.05). Computerized adjustable nasal positive airway pressure effectively controls OSA, fluidly providing the minimal pressure necessary to control respiratory events without causing sleep disruption.