Ficker J H, Wiest G H, Lehnert G, Wiest B, Hahn E G
Medical Department I, University of Erlangen-Nuremberg, Germany.
Thorax. 1998 Aug;53(8):643-8. doi: 10.1136/thx.53.8.643.
Auto-CPAP machines used in the treatment of obstructive sleep apnoea (OSA) are designed to vary the treatment pressure automatically in order always to apply the actually needed pressure. Consequently they should be able to achieve at least identical therapeutic effects as conventional constant pressure CPAP with a lower mean treatment pressure. The present study was designed to evaluate the therapeutic efficacy and the treatment pressure of an auto-CPAP machine (REM + auto, SEFAM) in comparison with a conventional CPAP device.
Following CPAP titration, 16 patients with OSA were allocated to receive conventional CPAP and auto-CPAP treatment under polysomnographic control in a randomised order. After each treatment the patients were asked to assess the therapy using a questionnaire; a vigilance test was also carried out and subjective daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS).
The mean (SD) apnoea/hypopnoea index (AHI) during auto-CPAP treatment was comparable with that during conventional CPAP treatment (4.2 (5.1) versus 3.6 (4.0)). Neither an analysis of sleep architecture nor the arousal index (7.4 (4.1) versus 7.0 (4.3)) revealed any significant differences. Daytime sleepiness measured with the ESS was also comparable (5.3 (3.4) versus 6.5 (4.2)). The vigilance test showed normal values after both treatments in all patients with no significant differences. The mean pressure during auto-CPAP treatment (8.1 (2.9) mbar), however, was significantly higher than that employed in conventional CPAP treatment (7.6 (2.7) mbar; mean difference 0.5 mbar; 95% CI 0.1 to 0.9 mbar; p < 0.05).
Auto-CPAP was equally as effective as conventional CPAP with respect to therapeutic efficacy. The aim of reducing the treatment pressure with auto-CPAP, however, was not achieved.
用于治疗阻塞性睡眠呼吸暂停（OSA）的自动持续气道正压通气（Auto-CPAP）机器旨在自动改变治疗压力，以便始终施加实际所需的压力。因此，它们应能够在较低的平均治疗压力下实现与传统恒压CPAP至少相同的治疗效果。本研究旨在评估一种自动CPAP机器（REM + auto，SEFAM）与传统CPAP设备相比的治疗效果和治疗压力。
在CPAP滴定后，16例OSA患者被随机分配，在多导睡眠图监测下按随机顺序接受传统CPAP和自动CPAP治疗。每次治疗后，要求患者使用问卷评估治疗效果；还进行了一项警觉性测试，并使用爱泼华嗜睡量表（ESS）评估主观日间嗜睡情况。
自动CPAP治疗期间的平均（标准差）呼吸暂停/低通气指数（AHI）与传统CPAP治疗期间相当（4.2（5.1）对3.6（4.0））。睡眠结构分析和觉醒指数（7.4（4.1）对7.0（4.3））均未显示任何显著差异。用ESS测量的日间嗜睡情况也相当（5.3（3.4）对6.5（4.2））。警觉性测试显示，所有患者在两种治疗后的值均正常，无显著差异。然而，自动CPAP治疗期间的平均压力（8.1（2.9）毫巴）显著高于传统CPAP治疗时使用的压力（7.6（2.7）毫巴；平均差异0.5毫巴；95%可信区间0.1至0.9毫巴；p<0.05）。
在治疗效果方面，自动CPAP与传统CPAP同样有效。然而，降低自动CPAP治疗压力的目标并未实现。
