Abstract
Background Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA). Automatic positive airway pressure (APAP) at home might be an alternative choice to identify optimal treatment pressure for OSA patients requiring CPAP treatment. Data on the association of effective treatment pressure between laboratory polysomnography (in-lab PSG) and home APAP has been limited. The aim of this study was to determine the correlation of effective CPAP pressure between in-lab PSG and home APAP. Methods A prospective cohort study was conducted. OSA participants aged 18 years or older who required CPAP therapy were included. Patients underwent in-lab PSG with manual CPAP titration to identify an effective treatment pressure. Patients also underwent APAP at home for 2 weeks to identify 95 percentile treatment pressure as an effective pressure. Results Fifty OSA patients (82% male) were included. Mean age was 48.9±14.6 years. Body mass index was 28.7±6.1 kg/m2. Polysomnographic data showed the effective treatment pressure of 10.4±2.9 cmH2O and the apnea-hypopnea index was 55.1±29.0 events/hour. Severe OSA was 76%. Home APAP data showed effective treatment pressure of 10.8±1.8 cmH2O. There was positive correlation of effective pressure between home APAP and in-lab PSG (r=0.472, P=0.001). The equation for predicting an in-lab effective pressure was: predicted pressure (cmH2O) = 2 + (home APAP ⁎ 0.78). Bland-Altman analysis showed good agreement between them, with a low mean difference of -0.428 cmH2O and 96% within the limit of agreement. Conclusions Home APAP pressure is moderately positively correlated with in-lab PSG effective pressure. The accuracy of home APAP is in agreement with in-lab PSG with manual CPAP titration. This APAP might be able to determine an effective therapeutic pressure in the sleep laboratory for OSA treatment.
Funder
The financial support was provided by Thammasat University Hospital, Thailand.