Comparisons Of3Titration Methods Of Positive Airway Pressure For Obstructive Sleep Apnea Syndrome

To evaluate the efficacy and security of polysomnography-manual continuous positive airway pressure titration under polysomnography (PSG-CPAP), polysomnography-automatic positive airway pressure titration (PSG-APAP), automatic positive airway pressure titration (APAP) in patients with simple moderate to severe Obstructive Sleep Aapnea Syndrome(OSAS).20moderate to severe OSAS patients randomly underwent PSG-CPAP, PSG-APAP and APAP titration in3days apart. We compared the primary efficacy indicators (titrating pressures, residual respiratory events, sleep architecture) and safety indicators (skin compression injury, the subjective evaluation of comfort and complaint during titration). The results of efficacy indicators revealed that PSG-APAP, APAP and PSG-CPAP are all effective. Compared with the optimal pressure of PSG-CPAP titration, PSG-APAP and APAP90th centile pressures of the time were3.05cmH2O,2.55cmH2O higher respectively, P <0.01. However, there were no statistical significance between APAP and PSG-APAP titration, P>0.05. There were no statistical significance among the optimal pressure of PSG-CPAP, the mean pressures of PSG-APAP and the mean pressures of APAP, P>0.05. There were no statistical significance between the three titration on residue AHI (apnea/hypopnea index), P>0.05. There were significant decrease on ODI (oxygen desaturation index) after titration treatment, but there was no statistical sign ificance between PSG-CPAP and PSG-APAP titration, P>0.05. In improving ODI, they all effective. Compared with base line PSG, there were no statistical significance on SE (sleep efficiency) after PSG-CPAP and PSG-APAP titration, P>0.05, however, the ArI (arousal index), N1%and N2%were significantly decreased, P<0.05, N3%and R%were significantly increased, P<0.01, they both improved sleep structure, however, there were no statistical significance between PSG-CPAP and PSG-APAP titration, P>0.05.The results of safety indicators revealed that all the patients did not appear the skin compression injury and severe adverse events related the titration during the study. The main complaints of patients were sleep disturbance, eyes and mouth drier after wakening, headache, breath holding and slightly abdomen discomfortable during the study. So we think the mean pressures of PSG-APAP and APAP titration could determine the optimal pressure of CPAP for patients with moderate to severe OSAS, they all have enough safety and efficacy.