The new procedure for manual CPAP titration : the afternoon CPAP titration (aPT)

Study Objectives : Although the full-night continuous positive airway pressure (CPAP) titration (fnPT) has been recognized as the gold standard for determining an optimal therapeutic pressure for obstructive sleep apnea (OSA) treatment, it is labor-intensive, time-consuming because it requires overnight polysomnography attended by well-experienced sleep technologists. The aim of this study is to develop a practical and feasible alternative titration method. Methods : We assessed demographic data and diagnostic polysomnographic parameters, time spent in CPAP titration, CPAP efficacy and long-term adherence of the two groups of our OSA patients who had received CPAP titration either by fnPT (n = 46) or by afternoon CPAP titration (aPT, n = 22). Main results : Mean total recording time of aPT was significantly shorter than that by fnPT (p < 0.0001). There was no significant difference in mean residual apnea hypopnea index (AHI) on treatment, percent days with device usage, cumulative device usage hours during the 360 days, average device usage hours per day (360 days, days used), and percent of days with device usage ≥ 4 hours during the 360 days after starting CPAP treatment between the two groups. Conclusions : Our study demonstrated that aPT was feasible procedure as an alternative to fnPT.