Manel Lujandirector of the Pulmonology Service of the Parc Taulí Hospital in Sabadellshared at the last Congress of the Spanish Sleep Society (SES) a recent investigation that detailed that not all CPAP devices work the same for the treatment of sleep apnea. The reason for carrying out this analysis was the “increase in complaints from patients regarding the tolerance and comfort with your CPAP devices” faced with a change in devices motivated by the launch of the new contest in your region.

Thus, with the premise of understanding the why these differences and after verifying that the intrinsic characteristics of the device cause a patient to tolerate the technology better or worse, Luján confirmed that exist “differences in pressure stability level in a simulation environment. For this reason, the specialist has determined that “the patient should be listened to if there is a poor tolerance and change your CPAP if necessary”.

In turn, it has come to the conclusion that, depending on the characteristics and respiratory effort by the patientCPAP devices have “different behaviors in their technical characteristics, especially in its ability to maintain pressure stability, which is key in this treatment.” After analyzing up to six device models CPAP in different trials, the pulmonologist will start another study with up to nine models for more detailed analysis.

Technology and breathing patterns

After this first analysis, the specialist highlights Medical Writing that “the technology was studied in a simulated patient environmentmodifying the characteristics of both the simulator and the treatment device, programming breathing patterns typical of the simulator.” By simulating different types of breathing, Luján highlights that “the CPAP devices were subjected to different conditions and ventilatory patterns, seeing differences in pressure stability.

When a patient with sleep apnea does not tolerate their CPAP device, Luján considers that “there is an intrinsic behavior in some devices, which can be an objective reason for patients' complaints and therefore, it is key that pulmonologists are aware that Not all CPAP devices are equally tolerated by different types of patients. and that the choice of technology is key so that the patient can benefit from proper treatment. There are devices that In one patient they may not go well and in others they may be much better.”. Luján compares the work of pulmonologists with that of tailorsince “the specialist must make a tailored suit to the patient with the devices they have.”

“It is key for pulmonologists to be aware that not all CPAP devices They are equally tolerated by different types of patients

The clinical impact that a patient whose CPAP is not doing well may suffer, can cause, in the words of Luján, “problems with non-tolerance and use of the device in the short and long term. If the patient does not tolerate the device and the pulmonologist knows its characteristics, a hypothesis why it is not tolerated and change it with another one, knowing well the characteristics of the other device.”

Should quality be prioritized over savings in CPAPs?

The analyzes carried out to date on different CPAP technologies do not determine whether some of them they do not fulfill their function correctly. “The characteristics of the devices are detailed in the technical specifications of the competitions, but sometimes they can fall short. In a market that favors priceit turns out that some lower quality equipment is in it and until now we had not been able to understand that there were differences, both in the impact like in the comfort of the patients, the treatment and its results. Although the specialist does not believe that “a device has harmful characteristics for a patient,” it is essential to focus on the patients' ability to tolerate devices, since hours of adherence are a central part of the treatment and are directly linked to the patient's health results. In that sense, it is a reality that “the device is better tolerated by a type of patient.” Due to this, the specialist advocates continuing to explore characteristics.most subtle and fine devices”.

“The characteristics of the devices are detailed in the technical specifications of the competitions, but sometimes they can fall short”

Another of the unknowns that the study carried out so far has not been able to unravel is the definition of criteria for choosing CPAP therapies and how to put this into focus for the competitions, since on the one hand there are the technical characteristics of the equipment according to communicate and another is their applicability or behavior in the patient's clinical situation. To overcome this obstacle, Luján will carry out a broader study, “including more models and seeing if those of lower quality can cause more problems.” All results still need to be translated into clinical practiceso the pulmonologist aspires to “collect large numbers of patients with a test bench and analyze if there is some type of device that the “Patients with sleep apnea have worse tolerance.”

Most appropriate devices depending on the patient

The role of the pulmonologist is, according to the specialist, “to prescribe the best therapy to the patient who suffers from a sleep pathology. The aim is to provide tools so that the pulmonologist learn more about the features of CPAP devices. Knowledge of additional details is what the pulmonologist aspires to “provide among specialists, allowing them to choose better which device may be the most suitable for a specific patient.

After carrying out this research, Luján defends a double reading of CPAP therapy, stating that “not all companies that manufacture them are aware of what the impact of the design of your devices in a patient. “It is a market in continuous transformation.” In this sense, the weight is carried by pulmonologists, who may be unaware of the real demand for the different manufactured equipment that they may have for a patient. Furthermore, the specialist makes it clear that, if results are published that there is a device with certain characteristics and another with others, “manufacturers are responsible whether or not to want to modify the technology. The conclusions drawn now will not be the same as those drawn two years from now.”.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any health-related questions be consulted with a healthcare professional.

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