6533b862fe1ef96bd12c6c00

RESEARCH PRODUCT

Automatic bilevel ventilation (AutoBI) in obstructive sleep-disordered breathing (SDB): clinical features and compliance to treatment

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CPAP is the first-choice treatment for obstructive SDB, but the criteria to prescribe AutoBI are undefined. Trials of AutoBI ventilation in patients under titration for obstructive SDB from January 2015 to January 2017 ((n=67 out of 265 titrations) were reviewed to assess: a) their clinical features, b) the reason to shift from CPAP to AutoBI, and c) long-term compliance to treatment. AutoBI was used in cases of intolerance to high therapeutic CPAP levels (n=23) or incomplete resolution of SDB on CPAP (n=45). AutoBI failed in 11 patients (16.4%): 2 OSA patients (7.7%), 4 overlap patients (21%), and 5 OHS patients (22.7%). The Table reports the differences at diagnosis between patients prescribed CPAP or AutoBI (unpaired t-test, significance p<0.05): The number of comorbidities was higher in Overlap than in OSA or OHS patients (3.51±1.23 vs 2.78±1.28 and 2.82±1.14, respectively, p=0.001). Mean ventilator use (CPAP n=48, AutoBI n=41), for an average treatment of 8.2±5.4 months, was similar in AutoBI (5.15±2.32 h/day) and CPAP (4.29±2.18 h/day, p=0.07) groups. In conclusion, AutoBi is effective and well-tolerated in the majority of patients with obstructive SDB who need high therapeutic pressures or show incomplete resolution of SDB on CPAP. Compliance to treatment was not different between CPAP and AutoBi groups.