Inter-machine variability in the stability of continuous positive airway pressure

Abstract

Two studies were performed to investigate the differences in pressure stability performance of the continuous positive airway pressure (CPAP) machines used by our patients. The variations of mask pressures during each respiratory cycle were measured during overnight studies of two groups of patients with obstructive sleep apnoea, who were using either a Sleep-Easy III CPAP machine or a Si-Plan CPAP unit. The patients were well-matched for age, weight and neck circumference. The group using the Si-Plan unit had more constant mask pressures and were using lower CPAP pressures (mean 10.6 cmH2O) than those using the Sleep-Easy III machine (mean 13.8 cmH2O) (p < 0.02). The pressure stability performance of five CPAP machines used by our patients was also compared using standardized simulated patient breaths produced by a negative pressure cuirass pump. There were large differences between the machines in ability to maintain a constant pressure. Using a tidal volume of 0.5 l and peak flow rates of between 20-40 l · min-1 the pressure variation ranged from 0-67% of the minimum inspiratory pressure. The maintenance of a constant pressure during inspiration and expiration lowers the mean pressure required to eliminate obstructive sleep apnoeas and reduces the likelihood of pressure related side-effects.