Patients changing autopap pressure themselves - a study

Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure?

Thanks to "sleepyman" for finding and posting the above link to a study comparing treatment results from sleep clinic titrations vs titrations done by patients making their own pressure adjustments while using an autopap ("self-adjusting CPAP".)

This was a study in which patients were educated in how/why to change their treatment pressures themselves! They were given the keys to how to change pressure and allowed to "drive" their own machines. Yessss!!

Excerpts below:

Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure?

Michael F. Fitzpatrick, Christi E. D. Alloway, Tracy M. Wakeford, Alistair W. MacLean, Peter W. Munt, and Andrew G. Day

Departments of Medicine and Psychology, Queen’s University, Kingston, Ontario, Canada

"An educational model in which the patient is empowered with the understanding and ability to make decisions regarding treatment has been demonstrated to be successful in other medical conditions (16). We reasoned that a similar educational approach might be successful in patients with OSA who require CPAP treatment." (My note: think of the way diabetes patients are educated and allowed to self-administer insulin.)

"A strategy that empowers the patient with OSA with the freedom to alter CPAP appropriately in response to altered upper airway physiology is inexpensive and may prove advantageous in the latter situation and in the long-term management of the patient."

"The study protocol empowered each patient with the knowledge and capability of directing his or her own CPAP treatment during the self-adjusted CPAP treatment limb. This strategy has not previously been employed in CPAP treatment of OSA, but systematic evaluations of similar management approaches for other medical disorders have generated very positive findings and have been demonstrated to facilitate cost-effective treatment of those conditions (16, 51–53)."

"In summary, this study demonstrates that self-titration of CPAP in patients with OSA is as efficacious as manual titration in a sleep laboratory, with similar subjective and objective outcomes, and CPAP compliance. Clearly, for this strategy to be successful, the patient must understand when and how to change the CPAP. Although the patient population studied did include a wide age range, this strategy would not be feasible for intellectually disadvantaged patients and those with physical handicaps that would severely limit vision and/or manual dexterity. Nonetheless, the findings from this study imply that routine overnight polysomnography is unnecessary for the purpose of CPAP titration in many patients with OSA, provided that the patient is given some basic education and support."

Wow! This is HUGE!!!!
Thanks for the article, rested gal!

On one hand, I can't help but find it incredibly insulting that such a study was even conducted. (Its okay to give diabetics testing kits to determine their blood sugar level, and syringes to administer corrective medicine, but better do an in-depth study to see if those dumb apneacs could possibly have the ability to read data and adjust their own pressure .)

On the other hand, thank goodness it is now in black and white and it won't be much longer that we'll be subjected to those not-quite-rare-enough, self-righteous DMEs spewing misinformation, claiming we need their permission to make adjustments, and using ludicrous scare tactics about the dire consequences of patient-directed treatment in a vain attempt to hang on to their corner of the market. Gosh, whatever will they do for supplemental income when they can no longer get away with selling OUR instruction manuals on Ebay? (Instruction manuals some DMEs have even gone so for as to claim are illegal for us to possess, yet for some strange reason they have no qualms about selling to the general public for a profit.)

What a delightful turn of events! Its about time!!

Thanks so much for the link to the older topic about that same study, Guest. I'd forgotten (gawd, the aging brain cells) that mikesus had already posted it back in March. Wow, was he ever a whiz at finding interesting links. Still is...

In March, mikesus posted this study link and deserves the kudos!
http://ajrccm.atsjournals.org/cgi/conte ... /167/5/716

In the same discussion tomjax wrote:
Not sure if this is the study cited, but it is one done in Canada.:
http://www.sleep-solutions.com/clinical ... n_CPAP.pdf

Yep, the same study, perzackly!

excerpts from the above referenced study:

"...the study demonstrates that in combination with a modest amount of educational support (just 30 minutes), the patient with OSA is just as capable of performing an effective CPAP self-titration as a technologist..."

Perhaps another reason some DMEs are so desperately trying to get us to believe we should not be adjusting our own pressure (aside from $$), is the fact that this study proved we are considered educated enough to do so after only a 30 minute lesson. (Not much job security there....)