# Normalisation of AHI Under Positive Pressure Therapy Does Not Necessarily Mean Control of Symptoms: A Comparison of the Effectiveness of APAP and CPAP on Daytime Sleepiness and Nocturnal Urination

## TL;DR

This study shows that even when breathing improves with APAP therapy, symptoms like daytime sleepiness and nighttime urination may still persist.

## Contribution

The study compares APAP and CPAP effectiveness in controlling symptoms despite normalized AHI in obese men with OSAS.

## Key findings

- 71.4% of patients preferred CPAP over APAP after 6 months of treatment.
- AHI normalization under APAP does not guarantee symptom resolution.
- Standardized questionnaires are needed to evaluate treatment effectiveness beyond AHI.

## Abstract

In practice, many patients receive APAP treatment for the simple reason that it provides increased comfort and is easier for patients to accept and tolerate. Reality has proven that we have very many patients diagnosed with OSAS on APAP treatment, under which AHI has normalized, but patients continue to have remaining symptoms. Thus the question was born: is the persistence of remnant symptomatology under APAP related to the mode of ventilation in patients with normalized AHI? The target group was young obese men presenting to the urology service for nocturnal pollakiuria without urologic cause. After performing nocturnal ventilatory polygraphy, the patients were recommended APAP treatment for three months, subsequently, the patients were switched to CPAP treatment for another three months, thus comparing the results obtained. After 6 months of treatment, 71.4% of the subjects would opt to continue CPAP treatment. While a clear option for APAP treatment was expressed by 10.2%. Our research, suggests that we should not be misled by the normalization of AHI under APAP therapy, but to evaluate the patients also with the help of available and standardized questionnaires.