Predictive equations for CPAP titration in OSAS patients

Lacedonia, Donato; Sabato, Roberto; Carpagnano, Giovanna Elisiana; Carratù, Pierluigi; Falcone, A.; Gadaleta, Felice; Resta, Onofrio

doi:10.1007/s11325-010-0461-1

Cited by 12 publications

(16 citation statements)

References 21 publications

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“…Near-similar results were reported by Lacedonia et al who compared 3 predictive formulas (Stradling, Sériès, and Hoffstein), which were also used in our study, with both manual and auto-titration, and found that there were no differences in the determined pressures by Stradling and Sériès equations, and the titrated pressure, but significant difference in the pressure determined by the Miljeteig and Hoffstein equation. 25 According to Sadeghniiat-Haghighi et al, there was a statistically non-significant difference between mean pressure measured by manual method and the Loredo et al 16 formula, similar to our results; however, the differences were statistically significant when compared with calculated pressures, measured by Miljeteig and Hoffstein, 13 Lin et al, 38 and Hukins 39 equations. 37 Lee et al reported, in a study on Asians, that there was a positive correlation with no significant difference between the mean of manual titration pressure and of developed formula.…”

Section: Discussionsupporting

confidence: 86%

“…Also, several previous studies reported no significant difference regarding therapeutic pressure value between the two techniques. [25][26][27] Other studies that depended on other titration techniques also reported near-similar results. Rosen et al 28 and Kim et al 21 carried out studies that compare PSG-guided laboratory titration and home auto-titration, and reported near-similar pressures with a statistically non-significant difference recorded for both methods.…”

Section: Discussionsupporting

confidence: 57%

“…Also, several previous studies reported no significant difference regarding therapeutic pressure value between the two techniques. 25–27 …”

Section: Discussionmentioning

confidence: 99%

“…Predictive formulas, on the other hand, can be valuable if applied with prudence and after establishing the true efficacy. 25 Construction of own predictive formula for determining the effective pressure is not necessary; the formula that was derived from the same ethnicity can be adopted and used for the reference formula. 43 The limitations of our study include the fact that the studied patients were derived from only one sleep unit, which could lead to sampling bias.…”

Section: Dovepressmentioning

confidence: 99%

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

Elshahaat¹,

Mahfouz²,

Elshora³

et al. 2021

IJGM

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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:

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 57%

“…Also, several previous studies reported no significant difference regarding therapeutic pressure value between the two techniques. 25–27 …”

Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

See 2 more Smart Citations

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

Elshahaat¹,

Mahfouz²,

Elshora³

et al. 2021

IJGM

View full text Add to dashboard Cite

show abstract

“…Should they "replace" the gold standard of monitored titrations in a sleep laboratory? Although omitting the conventional procedure could potentially lead to significant financial savings and a shortening of waiting lists to perform polysomnography, manual titration of CPAP (the most labor intensive and expensive procedure) still prevails in official guidelines [26]. What is their role in "split-night" studies?…”

mentioning

confidence: 99%

Prediction formulas for nasal continuous positive airway pressure in patients with obstructive sleep apnea syndrome

Schiza

Bouloukaki

2011

Sleep Breath

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Since its original description in 1981 [1], continuous positive airways pressure (CPAP) is a well established effective and evidence-based treatment for moderate to severe obstructive sleep apnea (OSA) [2]. However, the determination of optimal CPAP pressure in the laboratory is time-consuming and expensive, contributing to delays in the treatment of this condition. As sleep laboratory availability and expense is an issue of concern, several methods that could shorten long waiting lists and lower costs have been suggested. These are split-night studies [3], auto-CPAP titration [4], home sleep diagnostic studies [5], unattended autotitrating home CPAP studies [6] and more recently CPAP prediction formulas [7][8][9][10].In this issue of Sleep and Breathing, Ozen K. Basoglu and colleagues of the Ege University of Turkey in their paper "Determination of new prediction formula for nasal continuous positive airway pressure in Turkish patients with obstructive sleep apnea syndrome" developed and validated a new prediction formula of optimal CPAP in a Turkish population with OSAS and compared the new formula with two previous formulas designed and validated in Caucasian and Asian populations. The new formula utilizes neck circumference (NC) and oxygen desaturation index (ODI). One of the previous formulas, the Hoffstein formula, utilizes the BMI, neck circumference and AHI in its prediction of the optimal CPAP pressure. This formula has been used for the determination of reference pressure by most investigators in the literature so far [11][12][13][14][15][16][17][18][19]. The other formula takes into account BMI and AHI in predicting the optimal CPAP pressure setting in Taiwanese population [9]. The authors found that there is no significant difference between the three formulas in predicting the optimal CPAP pressure setting and that the new formula performs better than the previous formulas, though the improved accuracy was not statistically or clinically significant.The study is of some interest as the new formula is the first prediction formula derived and validated in a Turkish population. It is known that ethnic variability and related lifestyle habits may strongly influence the anthropometric variables in the severity of OSAHS as well as the effective CPAP pressure [20]. Therefore, the purpose of the present study and the rationale for another CPAP prediction formula was to investigate possible ethnicity-related effects, and thus create an improved prediction formula for the estimation of the optimum CPAP pressure. However, this underlying assumption was not proved in the course of this study, as there was no difference in the CPAP pressures between CPAP prediction formulas for Caucasians, Asians and Turkish patients, and the authors conclude that race/ ethnicity may not be an important factor in predicting CPAP levels.In the literature several formulas have been used with varying degrees of success to determine the optimal CPAP pressure [7,10,21,22]. Nahmias et al. reported a formula including ideal body weight...

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Determination of new prediction formula for nasal continuous positive airway pressure in Turkish patients with obstructive sleep apnea syndrome

Başoğlu

Taşbakan

2011

Sleep Breath

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Predictive equations for CPAP titration in OSAS patients

Abstract: Manual or auto CPAP titration remains the best way to define the appropriate CPAP. However, predictive formulas can be useful if used with caution and always after verifying the real efficacy, particularly for patients needing higher pressure.

Cited by 12 publications

References 21 publications

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

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

Prediction formulas for nasal continuous positive airway pressure in patients with obstructive sleep apnea syndrome

Determination of new prediction formula for nasal continuous positive airway pressure in Turkish patients with obstructive sleep apnea syndrome

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