AI Article Synopsis
- The study aimed to create predictive equations for determining therapeutic continuous positive airway pressure (CPAP) based on home titration methods, factoring in the type of mask used.
- A total of 702 adult patients with obstructive sleep apnea were analyzed, and two models (M1 and M2) were developed to estimate CPAP requirements; M1 showed higher accuracy than M2.
- The results indicated that M1 had an error margin of ±3.2 cm HO, allowing 79% of patients to start using CPAP with reasonable accuracy compared to 64% for M2.
Article Abstract
Purpose: To develop equations to predict therapeutic continuous positive airway pressure (CPAP) based on home-based CPAP titration, including the type of interface used.
Method: Retrospective study conducted in adult patients with obstructive sleep apnea (OSA) who used home-based autoCPAP titration (AutoSet S10, ResMed). CPAP was obtained manually through a visual analysis of autoCPAP data (CPAP) and automatically using the 95th percentile pressure (CPAP). Multiple linear regression and K-fold cross-validation were applied. Independent variables were AHI, neck circumference (NC), BMI, and mask. Two formulas were generated based on mask and the Miljeteig and Hoffstein formula.
Results: We included 702 patients (174 women), median age, BMI and AHI of 58 years, 32 kg/m and 32 ev/h, respectively. Predictors for CPAP (M1) were BMI, NC, AHI and type of interface (R: 0.19); and for CPAP (M2), BMI, AHI and mask (R: 0.09). Error and precision between the formulas and CPAP were: 0 (CPAP/CPAP), and - 3.2 to 3.2 (CPAP) and - 4 to 4 cm HO (CPAP). CPAP was higher with oronasal mask (10 vs. 9 cm HO, p < 0.01). Accuracy defined as; a difference ± 2 cm HO between estimated CPAP and CPAP was greater in M1 than in M2 (79% vs. 64%, p < 0.01).
Conclusion: In both models, calculated error was close to zero. CPAP (± 3.2 cm HO) showed more precision than CPAP (± 4 cm HO). With M1 (CPAP), 79% of patients could start CPAP with reasonable accuracy (error of ± 2 cm HO).
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