Auto‐adjusted versus fixed positive airway pressure in patients with severe OSA : A large randomized controlled trial - Université de Reims Champagne-Ardenne Access content directly
Journal Articles Respirology Year : 2023

Auto‐adjusted versus fixed positive airway pressure in patients with severe OSA : A large randomized controlled trial

Vanessa Bironneau
Pierre Ingrand
  • Function : Author
Sandrine Pontier
  • Function : Author
Carmen Iamandi
  • Function : Author
Laurent Portel
  • Function : Author
Francis Martin
  • Function : Author
Anne Mallart
  • Function : Author
Lionel Lerousseau
  • Function : Author
Didier Alfandary
  • Function : Author
Virginie Levrat
  • Function : Author
Florence Portier
  • Function : Author
Renaud Tamisier
Frédéric Goutorbe
  • Function : Author
Claudio Rabec
François Codron
  • Function : Author
Guy Auregan
  • Function : Author
Magalie Mercy
  • Function : Author
Frank Soyez
  • Function : Author
Didier Recart
  • Function : Author
Marie‐françoise Vecchierini
  • Function : Author
Frédéric Gagnadoux
Jean‐claude Meurice
  • Function : Author

Abstract

Abstract Background and Objective Continuous positive airway pressure (CPAP) in the treatment of severe obstructive sleep apnoea (OSA) can be used in fixed CPAP or auto‐adjusted (APAP) mode. The aim of this prospective randomized controlled clinical study was to evaluate the 3 month‐efficacy of CPAP used either in fixed CPAP or APAP mode. Methods Eight hundred one patients with severe OSA were included in twenty‐two French centres. After 7 days during which all patients were treated with APAP to determine the effective pressure level and its variability, 353 and 351 patients were respectively randomized in the fixed CPAP group and APAP group. After 3 months of treatment, 308 patients in each group were analysed. Results There was no difference between the two groups in terms of efficacy whatever the level of efficient pressure and pressure variability ( p = 0.41). Exactly, 219 of 308 patients (71.1%) in the fixed CPAP group and 212 of 308 (68.8%) in the APAP group ( p = 0.49) demonstrated residual apnoea hypopnoea index (AHI) <10/h and Epworth Score <11. Tolerance and adherence were also identical with a similar effect on quality of life and blood pressure evaluation. Conclusion The two CPAP modes, fixed CPAP and APAP, were equally effective and tolerated in severe OSA patients.

Dates and versions

hal-04660693 , version 1 (24-07-2024)

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Vanessa Bironneau, Pierre Ingrand, Sandrine Pontier, Carmen Iamandi, Laurent Portel, et al.. Auto‐adjusted versus fixed positive airway pressure in patients with severe OSA : A large randomized controlled trial. Respirology, 2023, 28 (11), pp.1069-1077. ⟨10.1111/resp.14569⟩. ⟨hal-04660693⟩
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