'Auto-CPAP'-therapie des obstruktiven Schlafapnoe-syndroms: Eine prospektive randomisierte untersuchung wahrend der therapie-einleitung

Objective: The efficacy and acceptance of self-regulated continuous positive airway pressure (auto-CPAP) ventilation was compared with conventional CPAP administration in the treatment of patients with obstructive sleep apnoea. Patients and methods: Using a cross-over design, under polysomnographic monitoring in a sleep laboratory, 25 patients with obstructive sleep apnoea underwent conventional CPAP or auto-CPAP treatment. Using a questionnaire patients gave their assessment of its acceptability and efficacy after each treatment session. Results: The mean pressure during treatment was the same in the two groups (7.2 ± 1.9 versus 7.1 ± 1.9 mbar; no significant difference). Maximal pressure during auto-CPAP averaged 3.7 ± 2.1 mbar higher than during conventional CPAP ventilation. The mean apnoea- hypopnoea index (AHI) during auto-CPAP, 4.4 ± 4.3 mbar, during auto-CPAP was significantly higher than during conventional CPAP treatment (2.8 ± 2.8 mbar; P = 0.044). In eight patients on auto-CPAP an AHI of 5 or less could not be reached, while an AHI of 5 or less was obtained in all but three patients under conventional CPAP. In a subgroup of 17 patients, in whom reduction of AHI to at most 5 was achieved with both conventional and auto- CPAP, analysis of sleep pattern and arousals was similar with the two forms of ventilation. Several patients reported that with auto-CPAP falling in sleep was more difficult and they sleep less well. None of the patients preferred auto-CPAP. Conclusion: By means of the auto-CPAP neither a pressure reduction nor an improvement in compliance could be achieved. Therapeutic effectiveness was significantly less as with conventional CPAP therapy.