Journal of the Medical Association of Thailand Vol 96, No 9:SEPTEMBER 2013 0125-2208 96 9 2013 Sep Comparison of the Clinical Outcomes between Unattended Home APAP and Polysomnography Manual Titration in Obstructive Sleep Apnea Patients 1159 EN Krongthong Wongsritrang Sumet Fueangkamloon Original Article To compare the clinical outcomes and determine the difference in therapeutic pressure between Automatic positive airway pressure (APAP) and polysomnography manual titration. Fifty patients of obstructive sleep apnea (OSA), moderate to severe cases, were randomized into two groups of intervention: 95-percentile pressure derived from APAP titration and an optimal pressure derived from manual titration. Clinical outcomes were assessed before and after four weeks. The average 95-percentile pressure derived from APAP titration was 11.7±0.3 cmH2O with median mask leak 1.3 L/min. The average optimal pressure derived from manual titration was 8.2±0.3 cmH2O. Pearson correlation analysis showed weak positive correlation (r = 0.336, p = 0.017). The Epworth Sleepiness Score (ESS), Quality of life tests: PSQI (Pittsburg Sleep Quality Index), and SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey) were improved significantly in both groups, but there were no statistical significant differences between groups. An APAP titration is an effective method of pressure determination for conventional CPAP therapy and shows no difference in clinical outcomes comparing the standard titration. Obstructive sleep apnea Manual titration Autotitrating Positive airway pressure