Objective: To compare the clinical outcomes and determine the difference in therapeutic pressure between Automatic positive airway pressure (APAP) and polysomnography manual titration.

Material and Method: 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.

Results: 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.

Conclusion: 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.

Keywords: Obstructive sleep apnea, Manual titration, Autotitrating, Positive airway pressure