Comparison of the Clinical Outcomes between Unattended Home APAP and Polysomnography Manual Titration in Obstructive Sleep Apnea Patients

Krongthong Wongsritrang MD*, Sumet Fueangkamloon MD*

Affiliation : * Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

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

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