Comparison of 3 methods of continuous positive airway pressure titration for obstructive sleep apnoea

3 CPAP titration methods are compared in terms of clinical and physiological response to treatment at 1 month. Patients are randomised to a one of 3 different interventions. The intervention is one of 3 ways of determining the pressure for a patient's CPAP machine. This intervention occurs on the first night of treatment, i.e., during a night of sleep. The intervention compares one of 3 ways to determine the pressure or air needed during sleep to control obstructive sleep apnoea. The manual titration method involves a technologist monitoring the sleep of the patient while pressure is varied. The autotitration can be done in the laboratory or at home. The machine varies the pressure rather than the sleep technologist and provides a recommended pressure dependent on the changes in airflow as pressure is changed. In the laboratory autotitration the technologist can still help the patient if there are problems, eg a dry mouth, while pressure is applied. Assessments are made after one month on CPAP treatment at the pressure detemined above. Assessments are clinical questionnaire measures of sleepiness, quality of life, cognitive function and blood pressure are measured during the day and control of OSA is measured by monitoring during sleep in the sleep laboratory while on CPAP treatment.