Cargando…

Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration

BACKGROUND AND PURPOSE: This study was designed to investigate differences in the final recommended pressure setting between that derived from an autotitrating continuous positive airway pressure (APAP) device and manual in-laboratory continuous positive airway pressure (CPAP) titration, as well as...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Hyeyun, Lee, Mija, Hwangbo, Young, Yang, Kwang Ik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurological Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174110/
https://www.ncbi.nlm.nih.gov/pubmed/32319249
http://dx.doi.org/10.3988/jcn.2020.16.2.314
_version_ 1783524566551756800
author Kim, Hyeyun
Lee, Mija
Hwangbo, Young
Yang, Kwang Ik
author_facet Kim, Hyeyun
Lee, Mija
Hwangbo, Young
Yang, Kwang Ik
author_sort Kim, Hyeyun
collection PubMed
description BACKGROUND AND PURPOSE: This study was designed to investigate differences in the final recommended pressure setting between that derived from an autotitrating continuous positive airway pressure (APAP) device and manual in-laboratory continuous positive airway pressure (CPAP) titration, as well as the factors that influence pressure differences in patients with obstructive sleep apnea (OSA). METHODS: This study enrolled 50 patients with OSA. All patients underwent both APAP titration and manual CPAP titration. We obtained the average device pressure ≤90% of the time (APAP(90)) from the downloaded manual for the APAP machine and the optimal pressure obtained by manual CPAP titration (CPAP(manual)). We placed the subjects into three groups based on the pressure difference (ΔP) obtained by subtracting CPAP(manual) from APAP(90): 1) Pr(equal) (ΔP=0), 2) CPAP(manual)+ (ΔP ≤−1), and 3) APAP(90)+ (ΔP ≥1). Regression analysis was conducted to identify predictive factors associated with ΔP. RESULTS: The values of APAP(90) and CPAP(manual) were 9.50±3.03 cmH(2)O and 9.48±2.71 cmH(2)O (mean±SD), respectively (p=0.95). The Pr(equal), CPAP(manual)+, and APAP(90)+ groups comprised 9 (18%), 23 (46%), and 18 (36%) subjects, respectively. Regression analyses revealed that male sex [β=3.539, 95% confidence interval (CI)=0.040–7.039], body mass index (BMI) (β=0.186, 95% CI=0.020–0.352), and average usage per day (β=0.768, 95% CI=0.077–1.459) were associated with ΔP. CONCLUSIONS: While the mean pressure in the overall cohort did not differ significantly between APAP(90) and CPAP(manual), there was a discordance majority showing different single pressures obtained when applying the two titration methods. Being Male, having an increased BMI, and having an increased average usage per day of APAP were significantly correlated with increased ΔP in this study.
format Online
Article
Text
id pubmed-7174110
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Korean Neurological Association
record_format MEDLINE/PubMed
spelling pubmed-71741102020-04-23 Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration Kim, Hyeyun Lee, Mija Hwangbo, Young Yang, Kwang Ik J Clin Neurol Original Article BACKGROUND AND PURPOSE: This study was designed to investigate differences in the final recommended pressure setting between that derived from an autotitrating continuous positive airway pressure (APAP) device and manual in-laboratory continuous positive airway pressure (CPAP) titration, as well as the factors that influence pressure differences in patients with obstructive sleep apnea (OSA). METHODS: This study enrolled 50 patients with OSA. All patients underwent both APAP titration and manual CPAP titration. We obtained the average device pressure ≤90% of the time (APAP(90)) from the downloaded manual for the APAP machine and the optimal pressure obtained by manual CPAP titration (CPAP(manual)). We placed the subjects into three groups based on the pressure difference (ΔP) obtained by subtracting CPAP(manual) from APAP(90): 1) Pr(equal) (ΔP=0), 2) CPAP(manual)+ (ΔP ≤−1), and 3) APAP(90)+ (ΔP ≥1). Regression analysis was conducted to identify predictive factors associated with ΔP. RESULTS: The values of APAP(90) and CPAP(manual) were 9.50±3.03 cmH(2)O and 9.48±2.71 cmH(2)O (mean±SD), respectively (p=0.95). The Pr(equal), CPAP(manual)+, and APAP(90)+ groups comprised 9 (18%), 23 (46%), and 18 (36%) subjects, respectively. Regression analyses revealed that male sex [β=3.539, 95% confidence interval (CI)=0.040–7.039], body mass index (BMI) (β=0.186, 95% CI=0.020–0.352), and average usage per day (β=0.768, 95% CI=0.077–1.459) were associated with ΔP. CONCLUSIONS: While the mean pressure in the overall cohort did not differ significantly between APAP(90) and CPAP(manual), there was a discordance majority showing different single pressures obtained when applying the two titration methods. Being Male, having an increased BMI, and having an increased average usage per day of APAP were significantly correlated with increased ΔP in this study. Korean Neurological Association 2020-04 2020-04-02 /pmc/articles/PMC7174110/ /pubmed/32319249 http://dx.doi.org/10.3988/jcn.2020.16.2.314 Text en Copyright © 2020 Korean Neurological Association http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hyeyun
Lee, Mija
Hwangbo, Young
Yang, Kwang Ik
Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration
title Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration
title_full Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration
title_fullStr Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration
title_full_unstemmed Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration
title_short Automatic Derivation of Continuous Positive Airway Pressure Settings: Comparison with In-Laboratory Titration
title_sort automatic derivation of continuous positive airway pressure settings: comparison with in-laboratory titration
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174110/
https://www.ncbi.nlm.nih.gov/pubmed/32319249
http://dx.doi.org/10.3988/jcn.2020.16.2.314
work_keys_str_mv AT kimhyeyun automaticderivationofcontinuouspositiveairwaypressuresettingscomparisonwithinlaboratorytitration
AT leemija automaticderivationofcontinuouspositiveairwaypressuresettingscomparisonwithinlaboratorytitration
AT hwangboyoung automaticderivationofcontinuouspositiveairwaypressuresettingscomparisonwithinlaboratorytitration
AT yangkwangik automaticderivationofcontinuouspositiveairwaypressuresettingscomparisonwithinlaboratorytitration