Does the physiological success of CPAP titration predict clinical success?
Patients commencing continuous positive airway pressure therapy (CPAP) undergo overnight airway pressure titration in sleep centres to optimize breathing and sleep patterns. We tested the hypothesis that data from formal scoring of the sleep and breathing patterns observed at the best achievable pressure during titration can predict CPAP use and effectiveness, as our clinical experience suggested otherwise. The relationship between CPAP titration scores (apnoea/hypopnoea frequency, arousal frequency and sleep staging) and subsequent CPAP use was examined in 150 sleep apnoea/hypopnoea syndrome patients. One hundred patients were continuing CPAP therapy and 50 were randomly selected patients who had discontinued CPAP. Within the CPAP group, titration scores were compared with CPAP machine use, subjective daytime sleepiness and requirements for airway pressure adjustment. Respiratory irregularities and arousals during titration did not relate to outcome. Sleep-stage analysis revealed a we
