| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
Centre de Recherche,
Hôpital Laval, Institut Universitaire de Cardiologie et de
Pneumologie de l'Université Laval, Sainte-Foy, Québec G1V 4G5,
Canada
Correspondence to: Dr F Sériès email: frederic.series{at}med.ulaval.ca
Received 5 January 2000; Returned to authors 9 March 2000; Revised version received 17 April 2000; Accepted for publication 5 June 2000
BACKGROUND
Treatment
of the sleep apnoea/hypopnoea syndrome with nasal continuous positive
airway pressure (CPAP) conventionally requires a titration procedure in
a sleep laboratory. The upper airway has a hysteresis phenomenon which
accounts for a decrease in the effective positive pressure level once
an initial effective pressure setting has been reached. The aim of this
study was to quantify the difference in the initial and final effective
pressure settings when the titration sleep study takes into account
these possible changes in the effective pressure level.
METHODSEighty five
patients completed the study. During a titration sleep study the
pressure was increased by 1 cm H2O in a stepwise fashion
until obstructive respiratory events disappeared (effective pressure 1, Peff1). The pressure level was then decreased by increments of 1 cm H2O until breathing abnormalities reappeared. At
this time pressure was re-increased by increments of
1 cm H2O to normalise breathing (Peff2).
RESULTSThe mean (SD)
value of Peff1 was 9.5 (2.6) cm H2O. The
pressure was then reduced during 0.5 (0.6) hours to reach the minimal pressure (7.0 (2.0) cm H2O). The pressure obtained after
a downward titration had to be re-increased in 79 patients, the
Peff2 level being significantly lower than
Peff1 (8.9 (2.8) cm H2O, p = 0.0002), mean
difference 0.6 (1.5) cm H2O (95% confidence interval
0.29 to 0.93).
CONCLUSIONAttempts to
decrease the positive pressure level during conventional determination
of the effective pressure level allow a significant decrease in the
pressure setting. This should be taken into account in each patient who
requires an in-laboratory manual CPAP titration procedure.
This article has been cited by other articles:
|
|
 |
|
  M. H. Sanders, J. M. Montserrat, R. Farre, and R. J. Givelber Positive Pressure Therapy: A Perspective on Evidence-based Outcomes and Methods of Application Proceedings of the ATS, February 15, 2008; 5(2): 161 - 172. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. P. Patel, M. Ahmed, and I. Rosen Split-Night Polysomnography Chest, November 1, 2007; 132(5): 1664 - 1671. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kessler, E. Weitzenblum, A. Chaouat, C. Iamandi, and T. Alliotte Evaluation of Unattended Automated Titration To Determine Therapeutic Continuous Positive Airway Pressure in Patients With Obstructive Sleep Apnea Chest, March 1, 2003; 123(3): 704 - 710. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
