Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1998 Aug;53(8):643–648. doi: 10.1136/thx.53.8.643

Evaluation of an auto-CPAP device for treatment of obstructive sleep apnoea

J Ficker 1, G Wiest 1, G Lehnert 1, B Wiest 1, E Hahn 1
PMCID: PMC1745298  PMID: 9828849

Abstract

BACKGROUND—Auto-CPAP machines used in the treatment of obstructive sleep apnoea (OSA) are designed to vary the treatment pressure automatically in order always to apply the actually needed pressure. Consequently they should be able to achieve at least identical therapeutic effects as conventional constant pressure CPAP with a lower mean treatment pressure. The present study was designed to evaluate the therapeutic efficacy and the treatment pressure of an auto-CPAP machine (REM+auto®, SEFAM) in comparison with a conventional CPAP device.
METHODS—Following CPAP titration, 16 patients with OSA were allocated to receive conventional CPAP and auto-CPAP treatment under polysomnographic control in a randomised order. After each treatment the patients were asked to assess the therapy using a questionnaire; a vigilance test was also carried out and subjective daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS).
RESULTS—The mean (SD) apnoea/hypopnoea index (AHI) during auto-CPAP treatment was comparable with that during conventional CPAP treatment (4.2 (5.1) versus 3.6 (4.0)). Neither an analysis of sleep architecture nor the arousal index (7.4 (4.1) versus 7.0 (4.3)) revealed any significant differences. Daytime sleepiness measured with the ESS was also comparable (5.3 (3.4) versus 6.5 (4.2)). The vigilance test showed normal values after both treatments in all patients with no significant differences. The mean pressure during auto-CPAP treatment (8.1 (2.9) mbar), however, was significantly higher than that employed in conventional CPAP treatment (7.6 (2.7) mbar; mean difference 0.5 mbar; 95% CI 0.1 to 0.9 mbar; p<0.05).
CONCLUSIONS—Auto-CPAP was equally as effective as conventional CPAP with respect to therapeutic efficacy. The aim of reducing the treatment pressure with auto-CPAP, however, was not achieved.



Full Text

The Full Text of this article is available as a PDF (115.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berthon-Jones M. Feasibility of a self-setting CPAP machine. Sleep. 1993 Dec;16(8 Suppl):S120–S123. doi: 10.1093/sleep/16.suppl_8.s120. [DOI] [PubMed] [Google Scholar]
  2. Condos R., Norman R. G., Krishnasamy I., Peduzzi N., Goldring R. M., Rapoport D. M. Flow limitation as a noninvasive assessment of residual upper-airway resistance during continuous positive airway pressure therapy of obstructive sleep apnea. Am J Respir Crit Care Med. 1994 Aug;150(2):475–480. doi: 10.1164/ajrccm.150.2.8049832. [DOI] [PubMed] [Google Scholar]
  3. Ficker J. H., Müller D., Wiest G., Lehnert G., Dertinger S. H., Katalinic A., Hahn E. G. Nasale CPAP-Therapie des obstruktiven Schlafapnoesyndroms mit exspiratorischer Druckreduktion: Eine prospektive randomisierte Untersuchung zur Akzeptanz der Behandlung während der Therapieeinleitung. Pneumologie. 1997 Jun;51(6):586–591. [PubMed] [Google Scholar]
  4. Ficker J. H., Wiest G. H., Lehnert G., Fischer C. J., Katalinic A., Hahn E. G. "Auto-CPAP"-Therapie des obstruktiven Schlafapnoe-Syndroms. Eine prospektive randomisierte Untersuchung während der Therapie-Einleitung. Dtsch Med Wochenschr. 1997 Nov 28;122(48):1482–1488. doi: 10.1055/s-2008-1047789. [DOI] [PubMed] [Google Scholar]
  5. Grunstein R. R. Sleep-related breathing disorders. 5. Nasal continuous positive airway pressure treatment for obstructive sleep apnoea. Thorax. 1995 Oct;50(10):1106–1113. doi: 10.1136/thx.50.10.1106. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hardinge F. M., Pitson D. J., Stradling J. R. Use of the Epworth Sleepiness Scale to demonstrate response to treatment with nasal continuous positive airways pressure in patients with obstructive sleep apnoea. Respir Med. 1995 Oct;89(9):617–620. doi: 10.1016/0954-6111(95)90230-9. [DOI] [PubMed] [Google Scholar]
  7. Hoffstein V., Viner S., Mateika S., Conway J. Treatment of obstructive sleep apnea with nasal continuous positive airway pressure. Patient compliance, perception of benefits, and side effects. Am Rev Respir Dis. 1992 Apr;145(4 Pt 1):841–845. doi: 10.1164/ajrccm/145.4_Pt_1.841. [DOI] [PubMed] [Google Scholar]
  8. Issa F. G., Sullivan C. E. Upper airway closing pressures in obstructive sleep apnea. J Appl Physiol Respir Environ Exerc Physiol. 1984 Aug;57(2):520–527. doi: 10.1152/jappl.1984.57.2.520. [DOI] [PubMed] [Google Scholar]
  9. Johns M. W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540–545. doi: 10.1093/sleep/14.6.540. [DOI] [PubMed] [Google Scholar]
  10. Kribbs N. B., Pack A. I., Kline L. R., Smith P. L., Schwartz A. R., Schubert N. M., Redline S., Henry J. N., Getsy J. E., Dinges D. F. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993 Apr;147(4):887–895. doi: 10.1164/ajrccm/147.4.887. [DOI] [PubMed] [Google Scholar]
  11. Lofaso F., Lorino A. M., Duizabo D., Najafi Zadeh H., Theret D., Goldenberg F., Harf A. Evaluation of an auto-nCPAP device based on snoring detection. Eur Respir J. 1996 Sep;9(9):1795–1800. doi: 10.1183/09031936.96.09091795. [DOI] [PubMed] [Google Scholar]
  12. Meurice J. C., Marc I., Sériès F. Efficacy of auto-CPAP in the treatment of obstructive sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1996 Feb;153(2):794–798. doi: 10.1164/ajrccm.153.2.8564134. [DOI] [PubMed] [Google Scholar]
  13. Meyer T. J., Eveloff S. E., Kline L. R., Millman R. P. One negative polysomnogram does not exclude obstructive sleep apnea. Chest. 1993 Mar;103(3):756–760. doi: 10.1378/chest.103.3.756. [DOI] [PubMed] [Google Scholar]
  14. Polo O., Berthon-Jones M., Douglas N. J., Sullivan C. E. Management of obstructive sleep apnoea/hypopnoea syndrome. Lancet. 1994 Sep 3;344(8923):656–660. doi: 10.1016/s0140-6736(94)92089-3. [DOI] [PubMed] [Google Scholar]
  15. Quatember R., Maly J. Neuropsychologische Untersuchungsmethoden altersspezifischer Leistungsparameter. Wien Med Wochenschr. 1980 Nov 15;130(21):688–692. [PubMed] [Google Scholar]
  16. Reeves-Hoché M. K., Hudgel D. W., Meck R., Witteman R., Ross A., Zwillich C. W. Continuous versus bilevel positive airway pressure for obstructive sleep apnea. Am J Respir Crit Care Med. 1995 Feb;151(2 Pt 1):443–449. doi: 10.1164/ajrccm.151.2.7842204. [DOI] [PubMed] [Google Scholar]
  17. Sanders M. H., Gruendl C. A., Rogers R. M. Patient compliance with nasal CPAP therapy for sleep apnea. Chest. 1986 Sep;90(3):330–333. doi: 10.1378/chest.90.3.330. [DOI] [PubMed] [Google Scholar]
  18. Stradling J. R., Barbour C., Pitson D. J., Davies R. J. Automatic nasal continuous positive airway pressure titration in the laboratory: patient outcomes. Thorax. 1997 Jan;52(1):72–75. doi: 10.1136/thx.52.1.72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Strohl K. P., Redline S. Nasal CPAP therapy, upper airway muscle activation, and obstructive sleep apnea. Am Rev Respir Dis. 1986 Sep;134(3):555–558. doi: 10.1164/arrd.1986.134.3.555. [DOI] [PubMed] [Google Scholar]
  20. Strollo P. J., Jr, Rogers R. M. Obstructive sleep apnea. N Engl J Med. 1996 Jan 11;334(2):99–104. doi: 10.1056/NEJM199601113340207. [DOI] [PubMed] [Google Scholar]
  21. Sullivan C. E., Issa F. G., Berthon-Jones M., Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet. 1981 Apr 18;1(8225):862–865. doi: 10.1016/s0140-6736(81)92140-1. [DOI] [PubMed] [Google Scholar]
  22. Sériès F., Marc I., Cormier Y., La Forge J. Required levels of nasal continuous positive airway pressure during treatment of obstructive sleep apnoea. Eur Respir J. 1994 Oct;7(10):1776–1781. doi: 10.1183/09031936.94.07101776. [DOI] [PubMed] [Google Scholar]
  23. Waldhorn R. E., Herrick T. W., Nguyen M. C., O'Donnell A. E., Sodero J., Potolicchio S. J. Long-term compliance with nasal continuous positive airway pressure therapy of obstructive sleep apnea. Chest. 1990 Jan;97(1):33–38. doi: 10.1378/chest.97.1.33. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES