Using Prediction Formulas for Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome

Continuous positive airway pressure (CPAP) is a standard therapy for patients with moderate to severe obstructive sleep apnea (OSA). Increased demands for polysomnography (PSG) and CPAP titration have led to long waiting lists and high cost. CPAP prediction formulas derived from sleep and anthropometric parameters are used to set the initial CPAP level during CPAP titration. In the current study, we aimed to compare the pressure derived from prediction formulas with the pressure resulted from CPAP titration in a sample of Iranian patients. In this cross-sectional study, 90 subjects with confirmed OSA in a full PSG who underwent CPAP titration in Baharloo Sleep Clinic, Tehran, Iran, during 2017, were enrolled. All of the participants had Respiratory Disturbance Index (RDI) ≥ 15 in their PSG test. Then, the optimal pressure obtained from manual CPAP titration was compared with the one calculated by different prediction formulas for each patient. The mean CPAP pressure from manual titration was greater than the pressures calculated by four prediction formulas. The difference between mean CPAP pressure obtained by manual titration and pressures calculated by Hoffstein, Lin, and Hukins formulas was statistically significant, whereas mean CPAP pressure obtained by manual titration was not statistically different from Loredo formula (11.7 ± 2.6 vs. 11.0 ± 2.3, P = 0.110). Estimation of optimal therapeutic pressure for CPAP device using several prediction formulas is very similar to pressure found during manual titration study. These formulas can be used in our setting for estimation of optimal CPAP pressure to save time and cost.