Comparisons of Continuous Positive Airway Pressures Determined by Conventional Manual Titration in a Sleep Center, During Sleep Endoscopy, and Auto-Titration at Home.
Drug-induced sleep endoscopy (DISE) could be valuable to determine an appropriate therapeutic pressure for obstructive sleep apnea (OSA).
The continuous positive airway pressure (CPAP) determined by DISE was regarded as equal to the conventional titrating pressure. There is no study comparing the DISE-titrating pressure and the home-based automatic CPAP (APAP) titrating pressure. This study compared the DISE-titrating pressure, conventional titrating pressure, and home-based APAP titrating pressure.
Retrospective comparative cohort study.
This study was conducted in a single medical center in Taiwan.
A total of 59 participants with OSA who had 3 titrating pressures determined by DISE, conventional titration and home-based APAP titration were analyzed.Interventions or Exposures:Therapeutic CPAP pressure was determined by 3 methods: DISE, conventional titration, and home-based APAP titration.
Home-based APAP titrating pressure was determined as 90% to 95% of APAP used at home for 2 weeks. The DISE-titrating pressure was determined manually based on direct visualization of upper airway patency during DISE examination. The conventional titrating pressure was determined manually under polysomnography (PSG) guidance in a sleep center. The correlation and difference between these 3 pressures were analyzed.
The home-based APAP titrating pressure, conventional titrating pressure, and DISE-titrating pressure were 8.8, 8.1, and 8.2 cmH2O, respectively. Good reliability was observed in pairs between all 3 pressures. The DISE-titrating pressure and the conventional titrating pressure were lower than the home-based APAP titrating pressure. There was no difference between the DISE-titrating pressure and the conventional titrating pressure.
DISE could help provide a therapeutic CPAP pressure similar to the conventional titrating pressure in sleep center and APAP titrating pressure at home.
DISE could be a valuable alternative titrating method, especially in countries where PSG is expensive, time-consuming and difficult to access, and could facilitate earlier and more effective management of patients with OSA.
The continuous positive airway pressure (CPAP) determined by DISE was regarded as equal to the conventional titrating pressure. There is no study comparing the DISE-titrating pressure and the home-based automatic CPAP (APAP) titrating pressure. This study compared the DISE-titrating pressure, conventional titrating pressure, and home-based APAP titrating pressure.
Retrospective comparative cohort study.
This study was conducted in a single medical center in Taiwan.
A total of 59 participants with OSA who had 3 titrating pressures determined by DISE, conventional titration and home-based APAP titration were analyzed.Interventions or Exposures:Therapeutic CPAP pressure was determined by 3 methods: DISE, conventional titration, and home-based APAP titration.
Home-based APAP titrating pressure was determined as 90% to 95% of APAP used at home for 2 weeks. The DISE-titrating pressure was determined manually based on direct visualization of upper airway patency during DISE examination. The conventional titrating pressure was determined manually under polysomnography (PSG) guidance in a sleep center. The correlation and difference between these 3 pressures were analyzed.
The home-based APAP titrating pressure, conventional titrating pressure, and DISE-titrating pressure were 8.8, 8.1, and 8.2 cmH2O, respectively. Good reliability was observed in pairs between all 3 pressures. The DISE-titrating pressure and the conventional titrating pressure were lower than the home-based APAP titrating pressure. There was no difference between the DISE-titrating pressure and the conventional titrating pressure.
DISE could help provide a therapeutic CPAP pressure similar to the conventional titrating pressure in sleep center and APAP titrating pressure at home.
DISE could be a valuable alternative titrating method, especially in countries where PSG is expensive, time-consuming and difficult to access, and could facilitate earlier and more effective management of patients with OSA.