Prospective cohort study of patients complaining of high pressure with CPAP/APAP (PAP) who switch to bi-level PAP (VAuto) as second-line therapy: POP-IN study

Some patients (pts) complain of high pressure with PAP devices that may contribute to poor sleep quality. Aim of this multicenter study was to assess pts who benefited from a switch to bilevel PAP therapy (AirCurve10 VAuto). 3 month FU results are presented here. Methods: 43 pts treated with PAP were enrolled in the study. Diagnostic PG data, PAP variables, VAuto settings, quality of sleep (PSQI), fatigue, sleepiness (ESS) & side effects were collected. At 3 months device data, PSQI, side effects & pts satisfaction were collected. Paired analysis are performed to compare variables change. Results: Population: mean Age:64±10.8y, BMI:30.7±5.8 kg/m², 27 men (66%), 21 HTA (53%), diag AHI: 46.6±19.5, 34 pts treated with APAP (85%). PAP mean pressure: 11.6± 2.3 cmH20, 95% pressure: 13.2 ±2.1 cmH20, mean leaks: 5.5±10.5 L/min, 95% leaks: 18.2±15.4 L/min. residual AHI: 4.7±3.3, daily usage: 5.6±2.0 h/d, % nights with usage>4h: 79±27%. VAuto mean EPAP: 8.3±2.6 cmH20, 95%: 10.3±2.8 cmH20 was reduced vs PAP (p PSQI was improved (p=0.023) as ESS & pichot (NS). Side effects were improved with VAuto: dry mouth (63 vs. 41% pts, p=0.033) & aerophagia (50 vs 19% pts, p=0.003). 90% of pts preferred VAuto to their previous PAP, 94.4% wanted to continue with the VAuto. Conclusion: Patients short-term quality of sleep, satisfaction and comfort were increased after a switch from PAP to VAuto, likely due to EPAP decrease and leaks reduction.