Trial reportSleep2011
Positive airway pressure initiation: a randomized controlled trial to assess the impact of therapy mode and titration process on efficacy, adherence, and outcomes.
Trial report in Sleep, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00636181 (Positive Airway Pressure Initiation), which is not on this map. Cited by 36 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Positive Airway Pressure Initiation: Impact of Therapy Mode and Titration Process on Adherence and Outcomes
Who cites it
36 citing papers in PubMed, 6 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Large variability in definitions of sleep apnea indices used in clinical studies.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Pooled it
- Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.The Cochrane database of systematic reviews · 2020Pooled it
- Pressure modification or humidification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.The Cochrane database of systematic reviews · 2019Pooled it
- Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Pooled it
- Trends in CPAP adherence over twenty years of data collection: a flattened curve.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2016Pooled it
- Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2016Pooled it
- What's leak got to do with it? Association of mask leak and positive airway pressure adherence from the homepap study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Trial
- Trial
- PAP Adherence and Nasal Resistance. A Randomized Controlled Trial of CPAPflex versus CPAP in World Trade Center Responders.Annals of the American Thoracic Society · 2021Trial
- Effect of cloud-based sleep coaches on positive airway pressure adherence.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Trial
- NightBalance Sleep Position Treatment Device Versus Auto-Adjusting Positive Airway Pressure for Treatment of Positional Obstructive Sleep Apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2019Trial
- The prevention of delirium in elderly with obstructive sleep apnea (PODESA) study: protocol for a multi-centre prospective randomized, controlled trial.BMC anesthesiology · 2018Trial
- Trial
- A multicenter evaluation of oral pressure therapy for the treatment of obstructive sleep apnea.Sleep medicine · 2013Trial
- Effectiveness of a group education session on adherence with APAP in obstructive sleep apnea--a randomized controlled study.Sleep & breathing = Schlaf & Atmung · 2013Trial
- Trial
- The effect of bilevel ventilation or modified continuous positive airway pressure on treatment adherence in adults with obstructive sleep apnea: a systematic review and meta-analysis.EClinicalMedicine · 2026Article
- Auto-adjusting positive airway pressure: the fine line between engineering and medicine.Sleep & breathing = Schlaf & Atmung · 2025Review
- Serendipity.Sleep advances : a journal of the Sleep Research Society · 2023Article
- APAP, BPAP, CPAP, and New Modes of Positive Airway Pressure Therapy.Advances in experimental medicine and biology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectives(1) To determine the efficacy of automatically adjusted positive airway pressure (APAP) with a comfort feature (A-Flex) at reducing apneas and hypopneas in participants with moderate to severe OSA. (2) To determine the relative difference between A-Flex, continuous positive airway pressure (CPAP), and APAP-derived optimal pressure for CPAP (CPAP(APAP)) on adherence to treatment. (3) To determine the relative difference between APAP with A-Flex, CPAP, and CPAP(APAP) on long-term change in functional outcomes.
designRandomized, double-blinded, 3-arm, multicenter trial.
settingUniversity and Veterans Affairs medical centers. PATIENTS OR
participants168 participants were randomized, and 140 completed the 180-day study.
interventions(1) A-Flex; (2) CPAP; (3) APAP for 14 days and then switched to CPAP at a fixed pressure. MEASUREMENTS AND
resultsApnea-hypopnea indices, average and minimum oxygen saturation, time spent < 90% were significantly poorer for A-Flex vs. CPAP at the initiation of study treatment; with the exception of minimum oxygen saturation, these differences were absent at 180 days. A-Flex had lower average leak values at both 3 and 6 months. There were no significant differences between groups in major efficacy, adherence, and outcome (subjective sleepiness, objective vigilance, blood pressure, quality of life) measures. No differences between groups in attitudes toward use were observed at 3 or 6 months; participant ratings for CPAP were significantly higher than A-Flex on treatment satisfaction and benefit, but not different for sleep quality and mask comfort.
conclusionsWe found that A-Flex shows equivalency, but non-superiority (except for average leak values), in efficacy, adherence, and functional outcomes compared to CPAP after either 3 or 6 months. CLINICAL TRIAL REGISTRY: Positive Pressure Treatment of Obstructive Sleep Apnea, http://www.clinicaltrials.gov, NCT00636181.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.