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  • Ambulatory titration of continuous positive airway pressure was as effective as polysomnography for obstructive sleep apnoea

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Therapeutics
Ambulatory titration of continuous positive airway pressure was as effective as polysomnography for obstructive sleep apnoea

https://doi.org/10.1136/ebm.12.5.148

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    Mulgrew AT, Fox N, Ayas NT, et al. Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. Ann Intern Med 2007;146:157–66.
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 Q In patients with a high probability of obstructive sleep apnoea (OSA), how does an ambulatory algorithm for titration of continuous positive airway pressure (CPAP) at home compare with titration by overnight polysomnography (PSG) in the sleep laboratory?

    Clinical impact ratings IM/Ambulatory care ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    not concealed.*

    Embedded ImageBlinding:

    blinded (data analysts).*

    Embedded ImageFollow-up period:

    3 months.

    Embedded ImageSetting:

    sleep disorders clinic in Vancouver, British Columbia, Canada.

    Embedded ImagePatients:

    68 adult patients (mean age 53 y, 77% men, mean body mass index 38 kg/m2) who had a high probability of moderate to severe OSA based on a clinical algorithm incorporating overnight oximetry in the home (positive predictive value 94%), were medically stable, and were not taking any sedative medications. Patients who had poor lung …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr F Ryan, The Lung Centre, Vancouver, BC, Canada. fryan{at}interchange.ubc.ca

    • Sources of funding: ResMed Corp; Vitalaire Canada Inc; Michael Smith Foundation for Health Research Infrastructure.

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2007; 12 160-160 Published Online First: 01 Oct 2007. doi: 10.1136/ebm.12.5.160