Age and Oronasal Mask are Associated with Lower Quality in Automatic CPAP Titration at Home in Patients without Previous Adaptation
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Abstract
Introduction: automated CPAP (APAP) titration at home is considered acceptable (TitAccept) when its device is used ≥ 4 hours/night and the residual apnea index (AHIr) es ≤ 10 events/hour (AASM). However, all the variables related to quality of this procedure are not fully known.
Objective: to assess the quality of the titration with APAP at home.
Material and Methods: Retrospective study in CPAP "naïve" patients. The TitAccept criterion selected two groups and multiple logistic regression identified predictors of non-acceptable titration.
Results: we included 1325 TitAccept; 941 men (71%), age: 57 ± 12.4 years, BMI: 32.3 ± 8.8 kg/m2, baseline AHI: 34.2 ± 19 ev/h. The titration reached 3.4 ± 3.5 nights, adherence: 379 minutes/night; effective pressure: 8.7 ± 1.7 cmH2O, AHIr; 3.1 ± 2.4 ev/h and leaks 16.1 ± 8.7 liters/min. The predictors were; age ≥ 50 years; OR: 1.62 (95%CI: 1.23-3.46), p: 0.0005 and oronasal mask; OR: 2.49 (95%CI: 1.79-3.46), p: 0.0001.
Conclusions: a significant proportion of patients who underwent an unsupervised APAP titration at home did not meet adequate test quality. Age ≥50 years and the use of an oronasal mask are associated with lower quality, according to pre-established criteria.
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