Which CPAP mode is more effective in patients with severe OSA?

Auto-adjusted (APAP) and fixed continuous positive airway pressure (CPAP) demonstrate similar efficacy in the treatment of severe obstructive sleep apnoea (OSA), a study has shown. Both CPAP modes are also well tolerated by patients with OSA.

In this prospective, randomized controlled clinical trial, the authors assessed the efficacy of the two CPAP modes—fixed CPAP or APAP—at 3 months. A total of 801 patients with severe OSA from 22 French centres participated in the study.

All patients were treated with APAP to determine the effective pressure level and its variability. After 7 days, participants were randomly assigned to the fixed CPAP group (n=353) or the APAP group (n=351). After 3 months of treatment, the authors analysed 308 patients in each group.

No between-group difference was observed in terms of efficacy, regardless of the level of efficient pressure and pressure variability (p=0.41). Specifically, 219 patients (71.1 percent) in the fixed CPAP group and 212 (68.8 percent) in the APAP group (p=0.49) had residual apnoea hypopnoea index (AHI) <10/h and Epsworh Score <11.

Tolerance and adherence between the two groups were also similar, with a comparable effect on quality of life and blood pressure evaluation.

“The two CPAP modes, fixed CPAP and APAP, were equally effective and tolerated in severe OSA patients,” the authors said.