Effects of three modes of respironics auto CPAP machines in patients with OSAHS

Introduction The effective treatment of for obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP). It is considered to be the gold standard treatment for moderate and severe OSA. However, compliance is the main challenge in CPAP usage because of lack of comfort. New technology has been tried to look for different modes to improve comfort ability of CPAP usage. Philips Respironics has designed productive algorithms that maintain effective therapy at minimal pressures. These modes are C-Flex and A- Flex: A-Flex makes each breath more comfortable at inhalation and exhalation. It provides flow- based pressure relief at the beginning of the exhalation. C-Flex makes sleep therapy more comfortable by reducing pressure at the beginning exhalation and returning to therapeutic pressure just before inhalation. OBJECTIVE: we aimed to differentiate the effects of three modes (A-Flex, C-Flex and 0- Flex) on CPAP compliance and comfort ability for randomized OSA patients. Materials and methods Randomized patients men and women who applied full-night Polysomnography in sleep lab,Clinical physiology Department,Sultan Qaboos University Hospital were diagnosed as moderate to severe obstructive sleep apneas. Auto CPAP Respironics machine was prescribed to these patients. This machine has two different pressure relief technologies (modes). These modes were breathing cycles (A-Flex and C-Flex). Comfort ability of CPAP was assessed using Visual Analogue Scale (VAS),AHI pre and post CPAP titration, O 2 desaturation pre and post CPAP titration, average leak and Epworth Sleepiness scale (ESS) to evaluate sleep pre and post of CPAP use. And compliance was assessed by usage (hours). Results Data were collected from 100 (60 males & 40 females) with average age of 30–60 years old and diagnosed as moderate to severe OSA with mean AHI of 52/h & SD of 33.2. Patients who had treated with A-flex showed more comfort ( P  = 0.02) using VAS compared to patients who had treated with C-flex and 0-flex modes. There was no difference in AHI and CPAP pressure among all modes. Conclusion The study showed that A-flex is more comfortable to patients compared to other modes of auto CPAP treatment. Acknowledgements department of clinical physiology, Sultan Qaboos University Hospital.