Related Experiment Video
Updated: May 24, 2026
07:40
Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
A pilot study assessing adherence to auto-bilevel following a poor initial encounter with CPAP
Eric D Powell1, Peter C Gay, Joseph M Ojile
1Sleep Therapy & Research Center, San Antonio, TX 78229, USA. powell.eric@sleeptrc.com
Summary
For obstructive sleep apnea (OSA) patients with poor initial continuous positive airway pressure (CPAP) experiences, auto bilevel devices did not significantly improve adherence compared to CPAP. However, both treatments led to comparable improvements in functional outcomes.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Obstructive sleep apnea (OSA) affects millions, often treated with continuous positive airway pressure (CPAP).
- Poor initial experiences with CPAP titration can lead to low adherence.
- Alternative positive airway pressure therapies are being explored for OSA patients with adherence challenges.
Purpose of the Study:
- To investigate if an auto bilevel device improves treatment adherence compared to CPAP in OSA patients with a history of poor CPAP titration.
- To assess the impact of auto bilevel versus CPAP on functional outcomes in this patient population.
Main Methods:
- A parallel-group, randomized, double-blind, controlled pilot study.
- 51 OSA patients with poor initial CPAP experiences were randomized to either an auto bilevel device or CPAP after in-lab titration.
- Treatment adherence and functional outcomes were assessed at 90 days.
Main Results:
- No significant difference in adherence (≥ 4 hours/night) was observed between the auto bilevel (62%) and CPAP (54%) groups at 90 days (p = 0.624).
- Both groups showed significant improvements in functional outcomes (p < 0.001) from baseline.
- Improvements in functional outcomes did not differ significantly between the two treatment groups.
Conclusions:
- Auto bilevel devices did not demonstrate a statistically significant advantage over CPAP in improving adherence for OSA patients with prior negative CPAP experiences.
- Patients with a poor initial CPAP exposure can still achieve acceptable long-term clinical outcomes with positive airway pressure therapy.
- Both auto bilevel and CPAP therapies resulted in comparable significant improvements in functional outcomes, sleepiness, and fatigue.
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation (NIPPV)
Noninvasive Positive-Pressure Ventilation (NIPPV)
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...