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Obstructive Sleep Apnoea Hypopnoea syndrome (OSAHS) is a potentially serious medical disorder associated with increased morbidity and mortality. It is estimated to affect 4% of males and 2% of females between the ages of forty and sixty. Nasal continuous positive airway pressure (CPAP) is the first choice treatment for this condition and it is extremely effective at controlling OSAHS. However, not all patients can tolerate this therapy, in particular those within the mild to moderate category, and there are also many others who are unable to comply with the minimum usage requirements of at least four hours every night. A new type of positive airway treatment, auto adjusting positive airway pressure (APAP) has been developed in the last decade, which theoretically should improve tolerance and therefore lead to higher compliance rates. The aim of this study was to determine whether patients with mild to moderate OSAHS tolerated auto-adjusting positive airway pressure better than traditional fixed positive airway pressure therapy by using the device for longer. No differences were found in respiratory abnormalities or daytime sleepiness, as assess by the Epworth Sleepiness Score (ESS) between the two modes of treatment, but all measured parameters were significantly improved form the baseline, untreated valued. Mean APAP pressure was significantly lower than CPAP pressure (6.2+-1.4 v 8.4+-1.7 cmH2O, p <0.001). Patient compliance and duration of use were similar with both treatments although there was a statistically significant proportion of patients requiring higher fixed pressure)>8 cm H2O), who preferred APAP while those requiring lower pressure (<8 cm>H2O) preferred CPAP. In conclusion APAP and CPAP are equally effective in resolving sleep related breathing disturbance and improving daytime sleepiness in patients with mild to moderate OSAHS, although compliance may be affected by fixed CPAP pressure requirements.
Nolan, Geraldine (Thesis), "Comparison of auto-adjusting and fixed level continuous positive airway pressure therapy in patients with mild to moderate obstructive sleep apnoea hypopnoea syndrome" (2004). Masters. Paper 29.