Reliability of automatic detection of AHI during mechanical ventilation

Automatic detection of residual AHI by the CPAP or NIV ventilators is a current practice both in the setting of titration procedures or follow-up monitoring. However, the reliability of this estimation has not been validated in a wide and composite population of OSA patients. We analyzed data of 300 patients already on treatment with different modalities of mechanical ventilation at home: 53% received CPAP, 28.5% auto-BiPAP, 8.8% PSV, 7,8% APAP and 1.7% of them ASV ventilation.  Oro-nasal mask was used in 53.6% of patients. All the patients underwent home full PSG or HRP: the respiratory data were compared with those registered by the ventilatory machine. Overall, the mean AHI detected during PSG (AHI PSG ) was higher than that detected by ventilator (AHI Vent ): 6.8±9.2 vs 4.3±6.3; p vent was higher than PSG (5±17.6 vs 4±17.4, respectively;p 5 (26.1% of total sample considering and AHI>15); 7% of patients were classified as not controlled despite the presence of AHIPSG Automatic detection of residual AHI by in-built software is frequently unreliable independently by ventilation modality or interfaces.