The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

DOES ACCURATE NIGHT BY NIGHT POSITIVE PRESSURE THERAPY INFLUENCE QUALITY OF LIFE OUTCOMES FOR OBSTRUCTIVE SLEEP APNOEA (OSA) PATIENTS?

Marshall MJ1, Scammels C1, Wiltshire N2, Buchanan F2, Catterall J2, Kendrick A2.
1Profile Respiratory Systems, Bognor Regis.
2Sleep Unit, Bristol General Hospital, Bristol. UK

Introduction: Traditionally, single night titration studies are performed in a Sleep laboratory to determine a long-term fixed pressure for Continuous Positive Airway Pressure (CPAP) treatment. It has been shown that there is no significant variation in the mean 95 centile pressure (95CP) over 7 consecutive nights of Auto-Adjusting Positive Airway Pressure (APAP) therapy, although individual differences do exist. When comparing the mean (95CP) of APAP over 7 nights against the 95CP of a single night laboratory titration there is a significant difference (p<0.05). (Marshall et al, Sleep Medicine. 2003).

Aim: The aim of our study was to retrospectively analyse, any difference in the Quality of Life (QoL) data in the group of subjects who had received both 30 consecutive nights of CPAP therapy and 30 consecutive nights of APAP therapy.

Methods:
QoL data (Functional Outcomes of Sleep Questionnaire (FOSQ)), from 26 compliant (4h per night for 70% of nights) male subjects, (mean age: 54±23 years, mean Body Mass Index (BMI): 37±17 kg/m2) with a confirmed diagnosis of Obstructive Sleep Apnoea (OSA) was recorded using an Encore Proâ Smartcard on a Respironicsâ REMstarâ Auto device. Data was retrieved from all subjects at the start of therapy and 30 days post fixed pressure therapy and 30 days post auto-adjusting therapy.

RESULTS:
are as shown in the table (see attachment)

Conclusions:
Whilst a statistical significant difference between the mean 95CP CPAP (9.8cmH2O) and the mean 95CP(7 nights) APAP (11cmH2O)(p <0.05) seen in this group, the pressure difference was only 1.2cmH2O. Clinically this is often disregarded. Whether the significant difference in the QoL data is due to accurate night by night pressures, or the higher pressures delivered on APAP is unclear and warrants further investigation.

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