Auto-titrating versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: a systematic review with meta-analyses

Table 8 Rapid eye movement sleep (%) in randomized controlled trials of APAP versus CPAP

Study PMID	Baseline AHI (SD) [eligibility]	Baseline ESS (SD)	Duration (design)	Interventions	Number analyzed	Baseline (SD)	Change (final)	Net difference or difference	95% CI^a	P	Dropout (%)	Study quality
d'Ortho 2000 [32] 11035671	58 (6) [≥10]	12.7 (5.3)	2 months (XO)	APAP	25	16 (5)	5	-1	nd	nd	0	B
				CPAP	25	16 (5)	6
Hussain 2004 [20] 15072173	47 (36) [> 15]	11.1 (6.4)	1 month (XO)	APAP	10	15 (7.0)	4.0	-1	-4.72 to 2.72	nd	0	C
				CPAP	10	17.6 (5.1)	2.0
Konermann 1998 [31] 9515848	38 (14) [> 20]	nd	3 to 6 months (PL)	APAP	25	8.2 (8.1)	11.9	7.1	nd	NS	4	B
				CPAP	23	5.4 (6.0)	4.8
Meurice 2007 [13] 17638595	55 (10) [nd]	11.8 (4.9)	6 months (PL)	APAP (AutoSet)	15	18.9 (6.6)	-2.4	-2.9	-7.49 to 1.69	nd	15	B
				CPAP	14	19.1 (5.9)	0.5
Nolan 2007 [14] 17326544	15 (8) [≥5)	12.3 (4)	2 months (XO)	APAP	29	17.6 (5.1)	-0.5	-2.5	-5.11 to 0.11^b	0.06	15	B
				CPAP	29	17.6 (5.1)	2.0
Planes 2003 [29] 12683473	59 (17) [≥30]	15.1 (3.9)	2 months (PL)	APAP	16	12.4 (7.0)	4.2	0.5	-5.44 to 6.44	nd	14	C
				CPAP	14	13.7 (9.3)	3.7
Randerath 2001 [26] 11254519	35 (26) [≥10]	11.1 (5.1)	1.5 months (XO)	APAP	52	11 (8)	6.0	1	-0.63 to 2.63	nd	12	B
				CPAP	52	11 (8)	5.0
Resta 2004 [24] 15679008	47 (11) [> 30]	13.9 (3.2)	1 month (PL)	APAP	10	15.0 (8.1)	6.7	-2	-10.31 to 6.31	nd	0	C
				CPAP	10	15.9 (4.2)	8.7
Sériès 1997 [27] 9341056	44 (20) [nd]	15.5 (4.5)	0.75 months (PL)	APAP^c	12	nd	nd^d	-	-	NS	0	C
				CPAP	12	nd	nd
				APAP^e	12	nd	nd^d	-	-	NS
				CPAP	12	nd	nd

AHI: apnea-hypopnea index (events/hour); APAP: auto-titrating CPAP; CPAP: continuous positive airway pressure; ESS: Epworth Sleepiness Scale; nd: no data; NS: non-significant; PL: parallel design; XO: cross-over design. ^aEstimated from reported data. ^bEstimated from reported P value. ^cEstimated effective pressure. ^dDirections of changes not reported in the study. ^eMeasured effective pressure.

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