Published ahead of print on October 2, 2003, doi:10.1164/rccm.200304-542OC Am. J. Respir. Crit. Care Med., Volume 168, Number 12, December 2003, 1506-1511 A more recent version of this article appeared on December 15, 2003
Submitted on April 17, 2003 Randomized Short-Term Trial of Two AutoCPAP Devices versus Fixed CPAP for Treatment of Sleep ApneaOliver Senn1,1 Pulmonary Divison, University Hospital of Zurich, Zurich, Switzerland * To whom correspondence should be addressed. E-mail: pneubloc{at}usz.unizh.ch.
We evaluated efficacy of two different continuous positive airway pressure devices with automatic mask pressure adjustment (autoCPAP) in comparison to fixed CPAP in treating obstructive sleep apnea syndrome in 29 patients. Mean (±SE) apnea/hypopnea index was 46 ±4 per hour, Epworth score 14.2± 0.7. Patients were treated over 3 consecutive 1-month periods with 3 regimens in random order: an autoCPAP device responding to apnea/hypopnea and snoring (DeVilbiss AutoAdjustLT, Sunrise), another autoCPAP device responding to the latter and changes in flow contour (AutoSetT, ResMed), and fixed CPAP at the 90th pressure percentile titrated by autoCPAP over 2 weeks. Allowed pressure in autoCPAP mode was 4 to 15 cm H2O. At the end of each treatment period, symptoms, quality of life, vigilance, and nocturnal breathing disturbances were evaluated. All 3 treatment modalities improved symptoms, quality of life domains, and apnea/hypopnea index significantly, and to a similar degree. Mean (±SE) maintenance-of-wakefulness time increased by 4.5 ±1.8, 6.0 ±1.5, and 6.1 ±1.4 minutes with DeVilbiss AutoAdjustLT, AutoSetT, and fixed pressure CPAP, respectively (P<0.001 vs. baseline, P=NS for comparisons among the 3 modalities). We conclude that both autoCPAP devices were equally effective as fixed pressure CPAP in improving major outcomes during short-term therapy of sleep apnea. Key words: obstructive sleep apnea; autoCPAP; continuous positive airway pressure; therapy; compliance;
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