The efficacy of continuous airway positive pressure ventilation with a nasal mask mainly depends on the appropriateness of the effective positive pressure level. Conventionally, this level is determined from polysomnographic recordings using progressively increasing pressure levels to determine the point where episodes of apnea, hypopnea and snoring regress in all sleep phases and in all body positions. Since the first description of this method, many other titration methods have been proposed. Some use sophisticated signals such as the analysis of respiratory exertion level or limitation of inspiratory flow to provide a more precise titration which is particularly useful in cases where the classical titration method is insufficiently effective. Inversely, simplified methods have been examined from an economic point of view. These methods do not require the presence of a technician in a specialized laboratory where the waiting list for diagnostic tests is often long. Recordings during naps or short nights have been proposed for the more severe cases. Likewise titrations during simple polygraphy recordings or with an autoCPAP device have been shown to be effective in one-night laboratory recordings. Much work remains to be done to determine the effectiveness of these methods when used in the patient's home as well the long-term effects.

译文

带鼻罩的持续气道正压通气的功效主要取决于有效正压水平的适当性。通常,该水平是通过多导睡眠图记录来确定的,该记录使用逐渐增加的压力水平来确定呼吸暂停,呼吸不足和打鼾发作在所有睡眠阶段和所有身体位置中消退的点。自从首次描述该方法以来,已经提出了许多其他滴定方法。有些使用复杂的信号,例如分析呼吸消耗水平或限制吸气流量,以提供更精确的滴定,这在经典滴定方法无效的情况下特别有用。相反,从经济角度研究了简化方法。这些方法不需要专业实验室的技术人员在场,因为诊断测试的等待名单通常很长。对于较严重的病例,建议在午睡或短暂的夜晚进行录音。同样,在简单的测距记录过程中或使用autoCPAP设备进行滴定在一夜的实验室记录中也是有效的。要确定这些方法在患者家中使用时的有效性以及长期效果,还有许多工作要做。

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