Simultaneous use of CPAP, at-home testing effectively identifies incompletely treated OSA

MONTREAL — Combined use of continuous positive airway pressure and an at-home sleep testing device accurately identified elevated apnea-hypopnea indices in patients suspected of having incompletely treated obstructive sleep apnea, according to data presented at CHEST Annual Meeting 2015.

"We found significant differences in the degree of untreated [obstructive sleep apnea (OSA)] as determined by [continuous positive airway pressure (CPAP)] machines in comparison to simultaneous use of a home sleep testing device," Matthew Epstein, MD, FCCP, FAASM, associate director of Atlantic Health Sleep Centers in New Jersey, told Healio.com/Pulmonology.

Forty eight patients with OSA underwent a single night of home sleep testing using WatchPAT 200 (Itamar Medical) while simultaneously using CPAP.

Patients underwent testing because of suspicion of incompletely treated OSA, despite prior CPAP use.

The CPAP machine registered an apnea-hypopnea index (AHI) in the normal range (mean AHI 2.4) for each patient. However, simultaneous testing with the at home device identified 15 patients had an elevated AHI (mean 10.9) and an elevated respiratory disturbance index (mean 16.4).

Epstein told Healio.com/Pulmonology about some of the issues with CPAP testing and why it matters.

"CPAP machines may be inaccurate in determining optimal treatment pressures, which may have significant clinical implications for patients with OSA," he said.

Epstein also told Healio.com/Pulmonology that there is a reason to use CPAP simultaneously with at home sleep testing.

"Based on our findings, home sleep testing may be useful to evaluate patients using CPAP when there is clinical suspicion of incompletely treated OSA," he said. – by Ryan McDonald

Reference:

Epstein M, et al. Abstract 202640. Presented at: CHEST Annual Meeting 2015; Oct. 24-28; Montreal.

Disclosure: The researchers report no relevant financial disclosures.