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Comparing pressures required to abolish snoring and sleep apnea
1University of Toronto, Toronto, Canada. victor.hoffstein@utoronto.ca
Canadian Respiratory Journal
|December 26, 2001
Summary
For patients using continuous positive airway pressure (CPAP), a small pressure increase can effectively treat snoring and obstructive sleep apnea. This adjustment may eliminate the need for repeat titration studies.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
- Critical Care
Background:
- Snoring and obstructive sleep apnea (OSA) share underlying causes and respond similarly to continuous positive airway pressure (CPAP) therapy.
- Understanding the precise pressure requirements for each condition is crucial for optimizing CPAP treatment.
Purpose of the Study:
- To compare the pressure needed to eliminate apneas (POSA) with the pressure needed to eliminate snoring (PSNOR) in patients undergoing CPAP titration.
- To determine if PSNOR can reliably predict POSA for effective CPAP therapy.
Main Methods:
- A cross-sectional, nonrandomized cohort study was conducted.
- 441 patients with confirmed sleep apnea underwent CPAP titration using nocturnal polysomnography.
- Pressure was incrementally increased until snoring and/or apnea ceased or a maximum of 16 cm H2O was reached.
Main Results:
- The mean pressure to abolish snoring (PSNOR) was 8.3 ± 2.57 cm H2O, and the mean pressure to abolish apneas (POSA) was 7.9 ± 2.72 cm H2O (P<0.0001).
- PSNOR was within ±1 cm H2O of POSA in 75% of patients, within ±2 cm H2O in 92%, and within ±3 cm H2O in 97%.
Conclusions:
- The pressure required to eliminate snoring is very similar to that required to eliminate apneas.
- A modest empirical increase of 2 cm H2O in CPAP pressure for patients who continue to snore may resolve both snoring and apnea, potentially avoiding further titration studies.
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