Prospective study to evaluate AutoCPAP accuracy in treating respiratory effort: AutoCPAP vs CPAP

Introduction In our daily practice we have noticed that, particularly when there is a predominance of respiratory effort, AutoCPAP cannot always control patients’ symptoms and they appear to tolerate better a fixed CPAP pressure. However, in the literature, there is no evidence sustaining this observation. So we designed a prospective study to evaluate the best treatment modality for these patients. Methods We included patients with a Respiratory Disturbance Index (RDI) u003e 15events/h and Respiratory Rffort-Related Arousals (RERAs) u003e 50% of all the events. They started Auto CPAP S9 and then switched to a fixed CPAP pressure. After 3 months with each modality, all patients performed a polysomnography to evaluate its accuracy in treating respiratory sleep events. Results Seven patients completed the protocol. We observed a significant reduction in RDI (3,9±2,8; p=0,001) and in the mean number of RERAs (23,3 ±13,4; p=0,000) with AutoCPAP, but three patients maintained residual apnea (RDIu003e5 events/h). With fixed CPAP there was an additional reduction in the number of RERAs (0.6±1.5; p=0,004) and all had a RDI Discussion Both modalities were effective in treating respiratory sleep apnea, but CPAP was better at correcting respiratory effort and in controlling patients’ symptoms.