• Yuichi Chihara, Tomomasa Tsuboi, Takefumi Hitomi, Masanori Azuma, Kimihiko Murase, Yoshiro Toyama, Yuka Harada, Kensaku Aihara, Kiminobu Tanizawa, Tomohiro Handa, Chikara Yoshimura, Toru Oga, Kazuhiko Yamamoto, Michiaki Mishima, and Kazuo Chin.
• Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
• Sleep. 2013 Feb 1;36(2):229-36.

Study ObjectivesThere are no clinical data comparing adherence and quality of life between auto-adjusting positive airway pressure (APAP) and two different flex positive airway pressure (PAP) devices (A-Flex, C-Flex) in patients with obstructive sleep apnea (OSA).Design And SettingNinety-three patients in whom OSA was newly diagnosed were randomly assigned to receive 3 mo of APAP (n = 31), APAP with C-Flex (n = 31), or APAP with A-Flex (n = 31). Objective adherence was determined after 3 mo of CPAP treatment, and the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Calgary Sleep Apnea Quality of Life Index (SAQLI) were examined at baseline and after 3 mo. After 3 mo, patients in the APAP with A-Flex group and those in the APAP with C-Flex group were crossed over and those in the APAP group were switched to A-Flex for an additional 3 mo.Measurements And ResultsThe groups were similar demographically. Treatment adherence during the first 3 mo was significantly greater in the APAP with C-Flex group (APAP with C-Flex: 5.19 ± 1.84 h/night versus APAP: 3.96 ± 1.66 h/night versus APAP with A-Flex: 4.27 ± 2.12 h/night, P = 0.04). There was a significant improvement in two of four of the SAQLI domain scores and in the ESS and PSQI in the APAP with C-Flex group. Adherence significantly improved among the poor compliers (< 4 h/night of use) in the APAP group after change to APAP with A-Flex (P = 0.01).ConclusionsOf these three modes of PAP delivery, adherence was greatest with APAP with C-Flex.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00873977.

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