Scientific Investigations
A Pilot Study Assessing Adherence to Auto-Bilevel Following a Poor Initial Encounter with CPAP
http://dx.doi.org/10.5664/jcsm.1658
Eric D. Powell, Ph.D.1; Peter C. Gay, M.D.2; Joseph M. Ojile, M.D.3; Mikhail Litinski, M.D.4; Atul Malhotra, M.D.4,5
1Sleep Therapy & Research Center,San Antonio, TX; 2Mayo Clinic, Rochester, MN; 3Clayton Sleep Institute, St. Louis, MO; 4Brigham and Women's Hospital, Boston, MA; 5Harvard Medical School, Boston, MA
Study Objectives:
We hypothesized that early intervention with an auto bilevel device would improve treatment adherence compared to CPAP among OSA patients with a poor initial experience with lab-based CPAP titration.
Methods:
Patients with a poor initial CPAP experience were recruited for this parallel group, randomized, double-blind, controlled pilot study. After an in-lab titration, patients were randomized with either an auto-bilevel device or CPAP. Treatment adherence and functioning were assessed at 90 days.
Results:
We enrolled 51 subjects, with 47 completing the protocol. Groups were equally matched for gender, age, education, and OSA severity. There was no significant difference in the proportion of compliant subjects (≥ 4 h/night) between the auto bilevel and CPAP groups (62% vs. 54%; p = 0.624) after 90 days of use. Functional outcomes significantly improved in both groups during treatment use (p < 0.001) but did not differ between groups.
Conclusions:
There was no statistically significant difference in adherence between the auto bilevel and CPAP groups in this study. Patients with a poor initial CPAP exposure may still achieve an acceptable long-term clinical outcome. Both groups demonstrated comparably significant improvements in functional outcomes, sleepiness, and fatigue complaints over the treatment period.
Citation:
Powell ED; Gay PC; Ojile JM; Litinski M; Malhotra A. A pilot study assessing adherence to auto-bilevel following a poor initial encounter with CPAP. J Clin Sleep Med 2012;8(1):43-47.
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