Métodos alternativos de titulación de CPAP (Presión positiva continua de vía aérea)

Abstract

The sleep apnea and hypopnea syndrome (SAHS) is a disorder affecting 2%-4% of the adult population. Nasal continuous positive airway pressure (CPAP) is the most effective treatment in SAHS symptomatic patients. Standard practice for continuous positive airway pressure (CPAP) treatment in sleep apnea and hypopnea syndrome (SAHS) requires pressure titration during attended laboratory polysomnography. The aim of this procedure is to identify an effective pressure to remove apneas, hypopneas, snoring and arousals. However, polysomnographic titration is expensive and time-consuming. Autoadjusted titration with autoCPAP devices has been proposed to overcome these disadvantages. These devices monitor one or more of the following parameters snoring, flow or impedance in order to detect respiratory events and adjust the CPAP pressure. The prediction of CPAP pressure using la formula; which includes the apnea-bypopnea index (AHI) and the anthropometrical parameters has been proposed also. The aim of this study was to ascertain, in a large sample of CPAP-naive patients, whether CPAP titration performed by an unattended domiciliary autoadjusted CPAP device or with a predicted formula was as effective as CPAP titration performed by full polysomnography. The main outcomes were the apnea-hypopnea index and the subjective daytime sleepiness after fixed CPAP treatment.