Obstructive sleep apnea syndrome: Impact of Titration location on CPAP Compliance

Abstract

<bold>Introduction:</bold> Continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea syndrome is started after overnight titration. We aimed to assess the correlation between titration location and CPAP compliance. <bold>Methods:</bold> Patients diagnosed with obstructive sleep apnea syndrome and treated by CPAP [2019-2024] were included. CPAP compliance was evaluated after 1 year of follow-up. It was defined by the use of at least 4 hours per night for 70% of the nights. Two groups were compared: G1 (Home titration) and G2 (In-hospital titration). <bold>Results:</bold> We included 272 patients (G1: 236, G2: 36). Mean age: [G1:58+/-10 vs G2: 61 +/-10 years; p= NS]. Mean BMI: [G1: 36.4 vs G2: 40.2 Kg/m²; p=0.002]. Cardiovascular comorbidities were more frequent in G2 (p=0.008). Epworth score before treatment was: [G1:11,59 vs G2: 11.57; p=NS]. Mean effective pressure level was: [G1: 9 vs G2: 10 cm H20; p= NS]. Initial acceptance rates were similar in the 2 groups (p= NS), with similar tolerance during first night use (p= NS). The compliance was better in G2 (83% vs 58%; p=0.04) with a better impact on daytime sleepiness (p=0.013) and subjective sleep quality (p=0.007), fewer side effects (p= NS), fewer leaks (p= NS) and fewer residual events (p= 0.01). <bold>Conclusion:</bold> In-hospital titration of CPAP seems to provide better first-year compliance.