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

Table 9 Stage 3 or 4 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	44 min (36)	43	-9 min	nd	NS	0	B
				CPAP	25	44 min (36)	52
Hussain 2004 [20] 15072173	47 (36) [> 15]	11.1 (6.4)	1 month (XO)	APAP	10	14 (25)	-4.0	-8	-18.32 to 2.32	nd	0	C
				CPAP	10	14 (25)	4.0
Konermann 1998 [31] 9515848	38 (14) [> 20]	nd	3 to 6 months (PL)	APAP	25	13.2 (12.2)	14	7.8	1.8 to 13.7^b	< 0.01	4	B
				CPAP	23	11.4 (10.4)	6.2
Meurice 2007 [13] 17638595	55 (10) [nd]	11.8 (4.9)	6 months (PL)	APAP (AutoSet)	15	25.5 (14.7)	-4.4	-5.2	-13.51 to 3.11	nd	15	B
				CPAP	14	17.1 (7)	0.8
Nolan 2007 [14] 17326544	15 (8) [≥5)	12.3 (4)	2 months (XO)	APAP	29	13.7 (7.8)	1.3	0.3	-3.29 to 3.89^b	0.87	15	B
				CPAP	29	13.7 (7.8)	1.0
Randerath 2001 [26] 11254519	35 (26) [≥10]	11.1 (5.1)	1.5 months (XO)	APAP	52	14 (11)	0	-1	-3.45 to 1.45	NS	12	B
				CPAP	52	14 (11)	1.0
Resta 2004 [24] 15679008	47 (11) [> 30]	13.9 (3.2)	1 month (PL)	APAP	10	19.8 (10.9)	14	7.3	-2.35 to 16.95	nd	0	C
				CPAP	10	22.8 (12.5)	6.7
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.

ISSN: 2046-4053