Titulación domiciliaria de CPAP en el síndrome de apnea del sueño: ¿una, 3 ó 7 noches?

Los equipos automaticos de CPAP (APAP) permiten establecer la presion eficaz de tratamiento en pacientes con apnea del sueno, sin la necesidad de supervision y con un menor costo que las titulaciones realizadas bajo control polisomnografico. Entre estos, el Autoset (ResMed) modifica la presion entregada en base a la presencia de apneas y limitacion al flujo inspiratorio. Pacientes con sindrome de apnea/hipopnea del sueno (SAHS) fueron estudiados con este equipo durante 1 semana, luego de un periodo de al menos 60 dias de uso de CPAP con una presion arbitraria entre 8 y 9 cmH2O. Comparamos el valor de presion obtenido en 1, 3 y 7 noches de titulacion. Se establecio un cumplimiento minimo aceptable de 6 noches y un nivel de fuga promedio Automatic devices for auto-titrating positive airway pressure (APAP) enable to estimate the effective pressure level of treatment in patients with sleep apnea, without supervision by a technician and at a lower cost than attended polysomnography titration. One of these devices, Autoset (ResMed), modifies the delivered pressure based on the presence of apneas and inspiratory flow limitation. Patients with sleep apnea-hypopnea syndrome were studied with this device during a week, after more than 60 days of continuous positive airway pressure (CPAP) with anarbitrary pressure between 8 and 9 cm H20. The study compared the pressure level measured in 1, 3 and 7 nights. The recordings were considered acceptable if at least 6 nights were included, and the mean leak was less than 0.4 l/second. Twenty four patients were recruited for the study; 2 were excluded (one by high leak level, and another by using the equipment 1cm H20 in 6 patients between the first night and the mean of 7 nights (p