Objective: Snoring and obstructive sleep apnea share similar pathogenesis and similar response to treatment with continuous positive airway pressure (CPAP). The purpose of this study was to compare pressures required to abolish apneas (POSA) with pressures required to abolish snoring (PSNOR).
Design: Cross-sectional, nonrandomized cohort study.
Setting: Sleep disorders clinic at St Michael's Hospital - a tertiary referral centre and a teaching hospital of the University of Toronto, Toronto, Ontario.
Population Studied: Unselected consecutive 441 patients with confirmed sleep apnea who were undergoing a CPAP titration study in the sleep laboratory.
Interventions: Nocturnal polysomnography using CPAP titration protocol, which required incremental increases in pressure until snoring and apnea were abolished or a maximum pressure of 16 cm H2O was attained. PSNOR and POSA were recorded and compared.
Results: Mean (+/- SD) pressures required to abolish snoring and apnea were: PSNOR 8.3+/-2.57 cm H2O and POSA 7.9+/-2.72 cm H2O (P<0.0001). In 75% of patients, the PSNOR was within +/-1 cm H2O of the POSA; in 92%, it was within +/-2 cm H2O; and in 97%, it was within +/-3 cm H2O.
Conclusions: Empirically increasing pressure by 2 cm H2O in patients on CPAP who continue to snore may abolish snoring and apnea without the necessity of another titration study.
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