Different Continuous Positive Airway Pressure Titration Modalities in Obstructive Sleep Apnea Syndrome Patients

Abstract

Background: Patients with obstructive sleep apnea syndrome are mainly treated with continuous positive airway pressure. Polysomnography-guided full-night manual titration is the gold standard for continuous positive airway pressure titration, but it is cost-, time-, and effort-consuming. Alternative ways of titration are easier with less cost, time, and effort. In the era of the COVID-19 pandemic, the need to establish more safe strategies is increased. Aim: To choose a rapid, efficient, simple, and safe method with less effort and cost in the measurement of a suitable level of positive airway pressure in the management of obstructive sleep apnea syndrome. Methods: This study enrolled 48 adult patients who had been diagnosed with obstructive sleep apnea syndrome at our sleep unit and were candidates for treatment with continuous positive airway pressure according to AASM 2008 after exclusion of other sleep-related breathing disorders. All patients underwent both laboratory full-night manual titration and auto-titration (by Prisma20A of WEINMANN medical technology, Germany). Manual titration pressure and P95 of auto-titration were obtained and compared with calculated pressures by five predictive formulas (Miljeteig and Hoffstein, Sériès, Stradling, Loredo, and Lee). Results: Patients included in the study were 25 females (52.1%) and 23 males (47.9%) with a mean±SD of age of 49.98±10.36 years. Mean±SD of manual pressure was 10.44±2.49 cmH 2 O, P95 was 10.16±2.64 cmH 2 O, and calculated pressures by different equations were:

Correlation between Neck Circumference and Continuous Positive Airway Pressure among Patients of Obstructive Sleep Apnea

“…16 To prevent the associated comorbidities, the effective therapy is needed, and CPAP is the treatment that he recommends for the majority of patients who suffer from OSA. 17 This treatment relieves obstruction of the upper airway by raising intramural pressure, which ultimately results in compression therapy of the airway. 17,18 That clinical practice guideline offers suggestions for using PAP, methods for starting PAP treatment, and initiatives to encourage PAP compliance in people with OSA.…”

“…17 This treatment relieves obstruction of the upper airway by raising intramural pressure, which ultimately results in compression therapy of the airway. 17,18 That clinical practice guideline offers suggestions for using PAP, methods for starting PAP treatment, and initiatives to encourage PAP compliance in people with OSA. 19 Although in the past, a number of predicting algorithms basis on various characteristics, including BMI, NC, the minimum oxygen saturation, as well as other criteria, were developed to estimate a therapeutic CPAP level.…”

“…19 Although in the past, a number of predicting algorithms basis on various characteristics, including BMI, NC, the minimum oxygen saturation, as well as other criteria, were developed to estimate a therapeutic CPAP level. 17 Despite their accuracy, numerous practitioners have not been compelled to use these formulas in routine medical care. 17,20 However, there are certain limitations to our study that need to be considered in subsequent research.…”

“…17 Despite their accuracy, numerous practitioners have not been compelled to use these formulas in routine medical care. 17,20 However, there are certain limitations to our study that need to be considered in subsequent research.…”