Validation of APAP with P-Flex: A novel pressure delivery method

Background: PR1 REMstar Auto with the P-Flex comfort mode is an Automatic Positive Airway Pressure (APAP) that adapts to the patient9s pressure needs. P-Flex is a unique comfort mode that adjusts pressure based on airflow changes. P-Flex provides pressure relief at end inhalation and the beginning of exhalation. Pressure relief varies with pressure and patient flow. The aim of this study was to assess the effectiveness, comfort and pressure delivery of APAP with P-Flex. Methods: 32 patients (24 Male) (BMI 31.7 ± 4.5 kg/m2, age 52.4 ± 11), underwent diagnostic polysomnography (PSG). PSG were repeated after 3 months of treatment. Daytime sleepiness was assessed by Epworth Sleepiness Scale (ESS). Adherence was determined by the APAP device. The average pressure delivered by the APAP is compared with the pressure measured at the mask (pressure corresponding to the P-Flex effect). Results: Patients have severe Obstructive Sleep Apnea with an apnea hypopnea index (AHI) of 49.9 ±18 events/h and were sleepy (ESS>10). After 3 months of use, APAP with P-Flex reduced AHI to 4.3 ± 4.8, improved oxygen desaturation index from 31.6 ± 27.2 to 4.8 ± 5.7 events/h and reduced arousal index from 39.4 ± 18.1 to 2.6 ± 3.4 events/h (p Conclusion: In patients with severe OSA, APAP with P-Flex is well tolerated and effectively treats breathing events and OSA symptoms with a lower mean airway pressure.