All APAPs Are Not Equivalent for the Treatment of Sleep Disordered Breathing: A Bench Evaluation of Eleven Commercially Available Devices.

Abstract

STUDY OBJECTIVES:

This study challenged on a bench-test the efficacy of auto-titrating positive airway pressure (APAP) devices for obstructive sleep disordered breathing treatment and evaluated the accuracy of the device reports.

METHODS:

Our bench consisted of an active lung simulator and a Starling resistor. Eleven commercially available APAP devices were evaluated on their reactions to single-type SDB sequences (obstructive apnea and hypopnea, central apnea, and snoring), and to a long general breathing scenario (5.75 h) simulating various SDB during four sleep cycles and to a short scenario (95 min) simulating one sleep cycle.

RESULTS:

In the single-type sequence of 30-minute repetitive obstructive apneas, only 5 devices normalized the airflow (> 70% of baseline breathing amplitude). Similarly, normalized breathing was recorded with 8 devices only for a 20-min obstructive hypopnea sequence. Five devices increased the pressure in response to snoring. Only 4 devices maintained a constant minimum pressure when subjected to repeated central apneas with an open upper airway. In the long general breathing scenario, the pressure responses and the treatment efficacy differed among devices: only 5 devices obtained a residual obstructive AHI < 5/h. During the short general breathing scenario, only 2 devices reached the same treatment efficacy (p < 0.001), and 3 devices underestimated the AHI by > 10% (p < 0.001). The long scenario led to more consistent device reports.

CONCLUSION:

Large differences between APAP devices in the treatment efficacy and the accuracy of report were evidenced in the current study.

• Authors: Kaixian Zhu, Gabriel Roisman, Sami Aouf, Pierre Escourrou
• Journal: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (J Clin Sleep Med) Vol. 11 Issue 7 Pg. 725-34 (Jul 15 2015) ISSN: 1550-9397 [Electronic] United States
• PMID: 25766708 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 American Academy of Sleep Medicine.

Topics

• Automation
• Benchmarking (methods)
• Equipment Design
• Equipment Failure Analysis (methods)
• Equipment Safety
• Humans
• Positive-Pressure Respiration (instrumentation, methods)
• Reproducibility of Results
• Sleep Apnea Syndromes (diagnosis, therapy)
• Sleep Apnea, Central (diagnosis, therapy)
• Sleep Apnea, Obstructive (diagnosis, therapy)