الفهرس 
Introduction and Aim of the workOnly 14 pages are availabe for public view
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Abstract
This study was carried out to choose a rapid, efficient, and simple method with less effort and cost in the measurement of a suitable positive airway pressure level in the management of OSA patients.
For this purpose 48 patients (23 males and 25 females with age range between (27-67) years and their mean age were 49.98±10.3) with obstructive sleep apnea/hypopnea syndrome were included. The study was conducted in sleep disordered breathing unit, chest department, Zagazig university hospitals from October 2018 to October 2019.
The following data were done for all patients:
A. An informed consent was taken from the patients.
B. Process:
I- The following data were obtained from patient’s records:
1. Full medical history taking
2. Full Clinical examination: General & Local chest examination.
3. Plain chest x-ray.
4. Arterial Blood Gases (ABGs) (daytime & night ABGs).
5. Routine haematologic investigations
6- Assessment of OSA suspicion by different scores: (STOP BANG score, epworth sleepiness scale, berlin questionnaire, and modified mallampatti score).
7- Polysomnography: to ensure the diagnosis of OSA
II- The following was done for all patients:
8- Assessment of therapeutic level of CPAP pressure by three different CPAP titration modalities (manual, auto-titration, and 5 predictive formulas).
This study revealed the following results:
1- Among our studied patients; OSA was more prevalent in middle-aged adults (a range of age 27.0 – 67.0), obese, enlarged NC and WC.
2- Snoring was the most reported complaint among our patients, followed by daytime tiredness and sleepiness. Regarding other consequences of OSA, HTN was the most reported comorbidity followed by DM.
3- There were statistically non-significant differences among OSA severity categories as regards sex, age or special habits. But there were statistically significant differences between OSA severity categories as regards BMI and waist circumference.
4- There were statistically highly significant differences among OSA severity categories as regards daytime sleepiness, snoring, observed apneas, and insomnia and statistically significant differences between OSA severity categories as regards DM and cardiac diseases.
5- There were statistically significant differences among OSA severity categories as regards min. SPO2, ODI, max. systolic blood pressure, and snoring index.
6- Berlin questionnaire had the highest sensitivity in OSA suspicion followed by MMS and STOP BANG, the ESS had the lowest sensitivity. Regarding specificity; STOP BANG was the highest, followed by ESS then berlin, MMS was the least.
7- No significant differences with positive correlations were reported between manual pressure (gold standard) and with pressures of auto-titration, Sériès, Stradling, Loredo, and Lee equations (p=0.112, 0.09, 0.212, 0.213, and 0.657 respectively), but a statistically significant difference between CPAP titration with manual titration and Miljeteig and Hoffstein equation.
8- There were positive correlations with statistically non-significant differences between APAP titration with each of Sériès, Stradling, Loredo and Lee equations but there was a statistically significant difference between APAP titration with Miljeteig and Hoffstein equation.
9- To ensure the efficacy of autotitration, there was a statistically highly significant change in residual AHI after APAP from that of baseline AHI.
We concluded from this study:
1- In our Egyptian patients, obesity especially increased BMI and WC were the main risk factors for OSAHS which is associated with significant sleep abnormalities and comorbidities.
2- Autotitration and predictive formulas can be used with the same efficacy as the manual titration with less cost, effort, and time.
We recommended in our study:
1-As OSA is associated with a great burden on our population. So health education for the general population and physicians is recommended.
2-In periods of epidemics, predictive formulas for CPAP titration are considered the safest titration method.