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Abstract Introduction Auto-titrating Continuous Positive Airway Pressure devices (auto CPAP) has been reported to be safe and well tolerated in children. This study evaluates the impact of the implementation of the auto CPAP pathway on therapy wait times for obstructive Sleep Apnea (OSA) management in children. Methods All children 2-18 years of age diagnosed with OSA at Nationwide Children’s Sleep Center and started on PAP therapy in 2023 were included in the study. Descriptive statistics for demographics and student’s t -test to compare the two groups for time to initiation of therapy were calculated using R open-source software version 4.3.2. Results Among study participants, 30 children (mean age 14.6 years; range 9.7 to 17.6 years) were set on auto-CPAP and 32 children (mean age 13.4 years; range 5.7 to 17.9 years) were set up on CPAP after completing titration study. The median number of days from diagnostic PSG to auto-CPAP set up was 39 days (range of 9 to 139 days), as compared to a median of 74 days (range of 5 to 544 days) from diagnostic PSG to CPAP set up after completion of a titration study; P value was 0.002. The median number of days from order placement to auto-CPAP set up was 23 days (range of 2 to 69 days). Compliance data at 90 days was available in 17 children in the auto-CPAP group and 29 children in the titration-study CPAP group. A trend for higher compliance in auto-CPAP group (47%) versus the titration-study CPAP group (34%) was noted (P value = 0.09). Conclusion Implementation of auto-titration CPAP pathway significantly reduces the time to therapy initiation in children with OSA and should be offered when clinically indicated. Our results also indicate that delay from order placement to auto-CPAP setup is a key driver to delay in therapy initiation. Support (if any)
Berichon et al. (Sat,) studied this question.