AutoCPAP for the treatment of obstructive sleep apnea in children

INTRODUCTION: In-laboratory titration polysomnography (PSG) is standard to determine optimal therapeutic continuous positive airway pressure (CPAP) in children with obstructive sleep apnea (OSA). The use of auto-titrating CPAP devices (autoCPAP) as an alternative to CPAP titration has not been well studied in children. We hypothesized that autoCPAP-derived pressures (PMEAN, PPEAKMEAN, P90) would be similar to titration PSG pressure (PPSG). METHODS: Retrospective study of children with OSAS initiated on autoCPAP between 2007 and 2017, who used autoCPAP for at least 2 hours per night and who had adequate titration PSG were included in the analysis. AutoCPAP-derived pressures were obtained from usage downloads and compared to PPSG. PPSG predictive factors were analyzed by median regression. Non-parametric methods were used for analysis. RESULTS: Of 110 children initiated on autoCPAP, 44 satisfied inclusion criteria. Age (median (IQR)) was 13.01 (9.98, 16.72) years, 63.6% were obese. PPSG median[IQR] was 8[7-11] cmH2O, mean autoCPAP-derived pressure (PMEAN) 6.2[5.6-7.6] cmH2O, peak mean pressure (PPEAKMEAN) 9.4[7.7-11.1] cmH2O, and average device pressure