Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2017
Validation of the System One RemStar Auto A-Flex for Obstructive Sleep Apnea Treatment and Detection of Residual Apnea-Hypopnea Index: A European Randomized Trial.
Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Accuracy of residual respiratory event detection by CPAPs: a meta-analysis.Sleep & breathing = Schlaf & Atmung · 2023Pooled it
- Residual Apnoea-Hypopnoea Index Measurement from Positive Airway Pressure Devices versus Home Polygraphy: A Method Comparison Study Using Real-World Data.Respiration; international review of thoracic diseases · 2026Article
- Cheyne-Stokes respiration detected via CPAP devices as a digital biomarker for heart failure in obstructive sleep apnoea: systematic review.Sleep advances : a journal of the Sleep Research Society · 2026Article
- Apnea-hypopnea index estimation using overnight chest-wall accelerometry.Frontiers in sleep · 2026Article
- Auto-adjusting positive airway pressure: the fine line between engineering and medicine.Sleep & breathing = Schlaf & Atmung · 2025Review
- The Automatic Algorithm of the Auto-CPAP Device as a Tool for the Assessment of the Treatment Efficacy of CPAP in Patients with Moderate and Severe Obstructive Sleep Apnea Syndrome.Life (Basel, Switzerland) · 2022Article
- Telemonitoring for the Follow-Up of Obstructive Sleep Apnea Patients Treated with CPAP: Accuracy and Impact on Therapy.Sensors (Basel, Switzerland) · 2022Review
- A longitudinal study of the accuracy of positive airway pressure therapy machine-detected apnea-hypopnea events.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Electronic health record-derived outcomes in obstructive sleep apnea managed with positive airway pressure tracking systems.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Validating respiratory index of auto-titrating positive airway pressure device with polysomnography.Sleep & breathing = Schlaf & Atmung · 2021Article
- Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults: an American Academy of Sleep Medicine clinical guidance statement.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021Review
- Use of the WatchPAT to detect occult residual sleep-disordered breathing in patients on CPAP for obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- Impact of Mask Type on the Effectiveness of and Adherence to Unattended Home-Based CPAP Titration.Sleep disorders · 2019Article
- Improvement in Sleep-Disordered Breathing Indices Downloaded From a Positive Airway Pressure Machine Following Conversion of Atrial Fibrillation to Sinus Rhythm.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018Article
- Urgent Need to Improve PAP Management: The Devil Is in Two (Fixable) Details.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Article
- Man Versus Machine.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Article
Corrections and comments
- Commented on by
Authors and funding
12 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesAutotitrating continuous positive airway pressure (CPAP) devices adjust pressure in response to changes in airflow and are an alternative to attended in-laboratory titration polysomnography (PSG) to determine optimal pressure levels. The aim of this study was to compare the performance of the System One RemStar Auto A-Flex (Philips Respironics, Murrysville, PA, USA) automatically adjusted positive airway pressure (APAP) mode to manually titrated, fixed pressure CPAP and to validate the device's breathing event detection capabilities against attended in-laboratory PSG.
methodsSixty-one patients investigated in five centers for moderate to severe obstructive sleep apnea between May 2012 and June 2013 were invited to participate. Participants underwent two full-night attended polysomnograms in random order with manually titrated, fixed pressure CPAP versus APAP.
resultsFifty-three participants with a mean apnea-hypopnea index (AHI) of 45.9 ± 23 completed two sleep studies and were included in the analysis. There were significant but not clinically relevant differences between APAP and CPAP respectively: Apnea index [1.0 (2.8 ± 0.8), median (mean ± standard deviation)] versus [1.8 (5.3 ± 11.5)], p = 0.004; percentage of N1 sleep [12.3 (15.9 ± 0.5)] versus [14.3 (18.9 ± 12.7)], p = 0.028. AHI values differed between PSG [2.8 (5.5. ± 9.3)] and device [3.7 (6.0 ± 8.6)], p = 0.003). Regarding residual events detection, intraclass correlation coefficients for AHI were strong (0.956, p < 0.001) and the area under the curve was 0.988 (AHI cut-off value of 10).
conclusionsThe new APAP modality was effective and residual apnea-hypopnea indices calculated by the device strongly correlated to those assessed by PSG. COMMENTARY: A commentary on this article appears in this issue on page 167.
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.