Influence of nasal obstruction on auto-CPAP behaviour during sleep in sleep apnoea/hypopnoea syndrome
Unité de
Recherche, Centre de Pneumologie, Hôpital Laval, Université Laval,
2725 Chemin Sainte-Foy, Québec, Canada G1V 4G5
Correspondence to: Dr F Sériès.
Received 22 August 1997; Returned to authors 13 January 1998; Revised version received 6 March 1998; Accepted for publication 24 April 1998
BACKGROUND
Auto-CPAP
machines have been developed to adapt automatically the positive
pressure level to the required needs. The auto-CPAP response to
transient nasal obstruction was tested during sleep in patients with
sleep apnoea/hypopnoea syndrome (SAHS).
METHODSNasal
obstruction was induced by local instillation of histamine. Fourteen
nasal challenges were performed on eight patients, seven while the
patients were on the "Morphée plus" apparatus and the other seven
with the patients on the "Horizon" machine.
RESULTSNasal
resistance increased initially by a mean (SD) of 166 (66)% during the
trials with the "Morphée plus" and by 118 (44)% with the
"Horizon" machine. The increase in nasal resistance was always
accompanied by flow limitation with one exception. Mask pressure
initially decreased to the minimal permitted value as nasal resistance
increased with the "Morphée plus" device. A late increase of the
positive pressure level occurred sometimes. Mask pressure did not
change with increasing nasal resistance when the
"Horizon" device was used.
CONCLUSIONNeither the
"Morphée plus" nor the "Horizon" device abolished flow
limited breaths and resulting sleep fragmentation. We conclude that,
despite the different algorithm of pressure changes, these auto-CPAP
machines do not adequately respond to an acute increase in nasal resistance.
© 1998 by Thorax
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