CPAP Pressure Titration Could Be Omitted

Abstract Patients with OSA are usually treated by automatic CPAP or Fixed CPAP after pressure titration. However, compliance to fixed CPAP derived from manual titration is almost the same as the compliance to automatic CPAP although automatic CPAP is usually higher than manual titrated pressure. We hypothesized that all the patients could satisfactorily be treated by CPAP fixed at 10 cmH2O. Twenty-nine severe OSA patients (age 44.4±12.0 years, BMI 30.9±4. 9 kg/m2, AHI 70.8±17.2 events/h) whose 90% of automatic pressure 11 cmH2O (mean titrated pressure 13±2 cmH20) based on 5-ningts home titration or 1-night laboratory titration were invited to have an overnight full polysomnography under a fixed CPAP at 10 cmH2O. Two subjects whose AHI before treatment was 66.9 events/h and 79.3 events/h and was 13.2 events/h and 12.2 events/h after treatment respectively. However, the AHI in all other subjects under fixed CPAP at 10 cmH2O was lower than 10 events/h. The number of patients who preferred to be treated by Auto-CPAP was similar to that to be treated with fixed CPAP at 10cmH2O(p>0.05). Conclusion: A fixed CPAP at 10 cmH2O can be used to treat most severe patients even whose auto titrated pressure is higher than 10 cmH2O. Keywords: Obstructive sleep apnea; continuous positive airway pressure; titration