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Objectives: Continuous positive airway pressure (CPAP) therapy is the gold standard for obstructive sleep apnea (OSA) treatment. In order to improve CPAP adherence, it is important to follow up patients regularly and perform CPAP pressure control in patients who have persistent symptoms of sleep apnea. So, the aim of this study was to determine the patients who need pressure change during follow-up.
Methods: In this prospective study, OSA patients who were given CPAP therapy after polysomnography and manual titration between January 2017 and December 2018 were evaluated, and the ones having persistent symptoms of sleep apnea despite regular use of CPAP device were included. Auto-adjusting positive airway pressure (APAP) device was given for at least two days at home and need for CPAP pressure change was evaluated.
Results: Of these 32 patients [68.8% male, mean age 51.4±9.8, body mass index 31.8±6.1 kg/m2, apnea-hypopnea index 45.9±27.6/h], mean CPAP pressure was found as 8.0±2.6 cm H2O and duration of CPAP use was 39.7±24.7 months. There were more than 10% weight loss in 3 patients and more than 10% weight gain in one patient. Overall, an increase of 1.5±7.0 kg was observed. During follow-up, persistent sleep apnea symptoms were determined as unrefreshed sleep in 21 patients (65.6%), nocturnal chocking in 9 patients (28.1%), snoring in 9 patients (28.1%) and witnessed apnea in 4 patients (12.5%), whereas 11 patients had more than one symptom. After automatic titration at home with APAP device, CPAP pressure was increased in 20 (62.5%) and decreased in 2 (6.3%) patients, and there was no change in 4 patients (12.5%). In addition, CPAP device was replaced by APAP in 5 (15.6%) and by BPAP in one patient (3.1%).
Conclusion: In this study, it was concluded that there may be a need for pressure change of CPAP in OSAS patients. For this reason, patients given CPAP therapy should be checked at regular intervals and CPAP pressures should be reviewed in patients who continue to have OSAS complaints.