Auto bi-level pressure relief-PAP is as effective as CPAP in OSA patients--a pilot study.

Abstract

PURPOSE:

Continuous positive airway pressure (CPAP) is the therapy of choice for the treatment of obstructive sleep apnea (OSA). Not all patients can use CPAP therapy with adequate compliance. There is a need to develop more comfortable modes. Auto bi-level Pressure Relief-Positive Airway Pressure (ABPR-PAP) can be an alternative. We conducted a prospective double-blind, randomised trial to evaluate the efficacy and compliance of ABPR-PAP compared with CPAP in OSA patients.

METHODS:

We included 35 CPAP naive patients (age 53.3 ± 10.3 years, BMI 31.0 ± 5.0 kg/m(2), ESS 10.0 ± 4.2) diagnosed with moderate to severe OSA who underwent a successful CPAP titration. Patients were randomised into the CPAP or the ABPR-PAP treatment group. We used the same device (BIPAP® Auto, Philips Respironics) for CPAP or ABPR-PAP. Apnea-hypopnea index (AHI) was determined using polysomnography before (AHI 40.6 ± 18.3 per hour) and after treatment.

RESULTS:

Eighteen patients received CPAP and the remaining 17 received APBR-PAP. Groups were similar in terms of demographics and OSA severity. There were no serious adverse events during the trial. CPAP was fixed by a sleep expert and ABPR-PAP varied (range 5-15 cmH(2)O). AHI decreased in the CPAP group to 6.4 ± 5.7 per hour and in the ABPR-PAP group to 4.8 ± 3.6 per hour in the first night (N = 35). After 3 months, the AHI decreased in the CPAP group to 4.4 ± 5.3 per hour and in the ABPR-PAP group to 2.6 ± 3.8 per hour (N = 32). Differences between the groups were not statistically significant. There were no differences in compliance.

CONCLUSIONS:

ABPR-PAP is a promising new ventilation mode that enables effective treatment of OSA patients.

• Authors: Alexander Blau, Mihaela Minx, Jan Giso Peter, Martin Glos, Thomas Penzel, Gert Baumann, Ingo Fietze
• Journal: Sleep & breathing = Schlaf & Atmung (Sleep Breath) Vol. 16 Issue 3 Pg. 773-9 (Sep 2012) ISSN: 1522-1709 [Electronic] Germany
• PMID: 21874370 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Continuous Positive Airway Pressure (instrumentation, methods)
• Double-Blind Method
• Equipment Design
• Female
• Humans
• Male
• Middle Aged
• Patient Compliance
• Pilot Projects
• Polysomnography
• Prospective Studies
• Sleep Apnea, Obstructive (diagnosis, therapy)
• Sleep Stages (physiology)
• Therapy, Computer-Assisted (instrumentation, methods)