Dias C, Sousa L, Batata L, Reis R, Teixeira F, Moita J, Moutinho Dos Santos J
Sleep Medicine Center - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Sleep Medicine Center - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Rev Port Pneumol (2006). 2017 Jul-Aug;23(4):203-207. doi: 10.1016/j.rppnen.2017.04.002. Epub 2017 Jun 7.
Autotitrating positive airway pressure (APAP) is an accepted titration method to determine the optimal positive airway pressure (PAP), for the treatment of obstructive sleep apnea (OSA). The required duration of APAP monitoring to determine a fixed continuous positive airway pressure level still remains to be established. We aimed to evaluate the variation in PAP level, delivered by APAP devices, at different periods of treatment, to determine the APAP treatment duration required to reach an effective and stable PAP level.
A cross-sectional study of 62 patients newly diagnosed with OSA were evaluated after 3 months of APAP therapy. APAP data corresponding to the first day (D1), first week (W1), seventh week (W7) and twelfth week (W12) under APAP therapy was collected. For the analysis of the pressure behaviour, the difference of P95th pressure level between W12 and W7 (P W12-W7), W12 and W1 (P W12-W1) and W12 and D1 (P W12-D1) was calculated.
There was a high correlation in P95th pressure level between D1 and W12 (r=0.771; p>0.0001), W1 and W12 (r=0.817; p>0.0001), and W7 and W12 (r=0.926; p>0.0001). This correlation progressively increased with APAP use. A significance difference was found in concordance between P W12-W7 and P W12-D1 (p=0.046) within the pressure range ±2cmHO. However there was no significant difference in concordance between P W12-W7 and P W12-W1.
One week of APAP therapy seems sufficient to determine an effective and stable PAP level, within the pressure range ±2cmHO.
自动调压气道正压通气（APAP）是一种公认的用于确定最佳气道正压（PAP）以治疗阻塞性睡眠呼吸暂停（OSA）的滴定方法。确定固定持续气道正压水平所需的APAP监测持续时间仍有待确定。我们旨在评估APAP设备在不同治疗阶段输送的PAP水平变化，以确定达到有效且稳定的PAP水平所需的APAP治疗持续时间。
对62例新诊断为OSA的患者进行了一项横断面研究，在APAP治疗3个月后进行评估。收集了APAP治疗第1天（D1）、第1周（W1）、第7周（W7）和第12周（W12）对应的APAP数据。为了分析压力行为，计算了W12与W7之间（P W12-W7）、W12与W1之间（P W12-W1）以及W12与D1之间（P W12-D1）的第95百分位压力水平差异。
D1与W12之间（r = 0.771；p > 0.0001）、W1与W12之间（r = 0.817；p > 0.0001）以及W7与W12之间（r = 0.926；p > 0.0001）的第95百分位压力水平具有高度相关性。这种相关性随着APAP的使用而逐渐增加。在±2cmHO压力范围内，P W12-W7与P W12-D1之间的一致性存在显著差异（p = 0.046）。然而，P W12-W7与P W12-W1之间的一致性没有显著差异。
在±2cmHO压力范围内，一周的APAP治疗似乎足以确定有效且稳定的PAP水平。
