Comparison of Prediction Formulas for CPAP Titration in Patients with Sleep Apnoea Syndrome

Abstract

Continuous Positive Airway Pressure (CPAP) therapy has revolutionized the treatment of Obstructive Sleep Apnea Syndrome (OSAS), first reported in 1981. Manual CPAP titration can lead to a number of constraints and loss of time and labor for the patient and relatives, the healthcare worker, and the healthcare system. Therefore, the use of predictive forecasting formulas has a positive benefit. This study aims to compare the effectiveness of three widely used prediction formulas—Hoffstein, Loredo et al., and Hukins—against manually titrated CPAP pressure values in patients diagnosed with OSAS. The study included 69 patients first diagnosed with OSAS in our center's polysomnography (PSG) laboratory between 2010 and 2024 and underwent CPAP titration during a whole-night sleep study. Three predictive formulas were compared, and their agreement with manual titration was evaluated. The comparison of predicted pressures revealed that the Loredo formula provided the closest estimates to manual titration pressures, showing the least systematic difference (-0.07101) and absolute percentage error (11.11%). In contrast, the Hoffstein formula exhibited the highest systematic difference (-2.4174), while the Hukins formula had moderate predictive validity. Overall, the Loredo formula demonstrated superior accuracy in predicting CPAP titration pressures, suggesting that it may be a reliable alternative to manual titration methods in clinical practice. Future research should focus on validating these formulas across larger and more diverse populations to enhance their applicability in routine clinical settings.