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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Neurological Association
2020
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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 |
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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 |
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