Comparison of empirical continuous positive airway pressure (CPAP) treatment versus initial portable sleep monitoring followed by CPAP treatment for patients with suspected obstructive sleep apnoea.

摘要: Background:  Polysomnography is labour-intensive for diagnosing obstructive sleep apnoea (OSA). We compared two algorithms initiating continuous positive airway pressure (CPAP) treatment patients with suspected OSA. Methods:  Symptomatic OSA were randomised into either algorithm I or II. Algorithm consisted of an empirical CPAP trial whereas II utilised Apnea Risk Evaluation System, a wireless device applied on the forehead, establishing diagnosis before 3 weeks. Primary outcome was success trial, defined as usage > 4 h/night and willingness to continue CPAP. Subjective usefulness CPAP, accuracy System versus polysomnography adherence at 6 months secondary end-points. Results:  Altogether 138 in 110 completed trial. There no significant differences between these respect primary end-point. The sensitivity specificity diagnostic test 0.3, 0.8 0.31, 1.00 respectively. In predicting 6 months, likelihood ratio 2.7 5.27 mean (SE) time taken from first consultation end 60 (2) 98 (5) days, respectively, P < 0.01. Conclusion:  An ambulatory approach portable monitoring can identify more who would adhere than alone.