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. 2019 Dec 2;2019(12):CD003531. doi: 10.1002/14651858.CD003531.pub4

Noseda 2004.

Methods Randomised, single‐blind, cross‐over study. Method of randomisation: random numbers table.
Statistical analysis: student's t test (paired data)
Participants N = 27 participants (23 M/4 F). Withdrawals: 3. Total completed and analysed N = 24. Mean age: 49 years; BMI: 32.3 kg/m2; AHI: 50.9; ESS 10.7
Inclusion criteria: AHI > 20/hour; MAI: > 30/hour; high variability of within night pressure to correct AHI
Exclusion criteria: prior treatment with CPAP; central OSA/Cheyne Stokes; major facial abnormality; night/shift work; severe chronic heart failure/COPD; seizure disorder; mental retardation; sedative, hypnotic or antidepressant therapy; previous UPPP; prolonged hypoventilation during REM
Interventions Auto‐CPAP versus fixed CPAP. Need for pressure assessed over a 14‐night run‐in period with auto‐CPAP. No washout period described
Study duration: 2 x 8‐week treatment periods
Outcomes

  1. Machine usage (nights used effectively)

  2. Symptoms (ESS)

  3. Preference

  4. Treatment pressure

  5. Self‐estimated sleep latency
Funding & conflicts of interest statements Not provided
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Randomisation tables
Allocation concealment (selection bias) Unclear risk Information not available
Blinding of participants and personnel (performance bias) 
 Machine usage, symptoms, quality of life, withdrawal, adverse effects High risk Quote: ".....single‐blind, randomized, crossover trial........subjects were told that they would sleep with the machine functioning in two distinct modes.....no further explanation was given."
Blinding of participants and personnel (performance bias) 
 AHI, blood pressure, treatment pressure Low risk These outcomes unlikely to be affected by awareness of treatment group.
Blinding of outcome assessment (detection bias) 
 Machine usage, symptoms, quality of life, withdrawal, adverse effects High risk Single‐blind nature of the study means that these outcomes are at risk of bias
Blinding of outcome assessment (detection bias) 
 AHI, blood pressure, treatment pressure Low risk These outcomes unlikely to be affected by awareness of treatment group.
Incomplete outcome data (attrition bias) 
 All outcomes High risk Rate of participants not crossing over could be high enough to introduce bias
Selective reporting (reporting bias) Low risk All outcomes reported
Other bias Low risk No concerns identified