FIG. 47: In terms of treatment interventions, an important point is that patients randomized either to HOT alone or to HOT plus home NIV or HMV were prescribed similar O2 levels on both arms; ie, addition of home ventilation was not used simply to facilitate high levels of O2 flow, as they were similar in both groups.[1]

The a priori titration policy led to relatively high inspiratory positive airway pressure (IPAP) levels, median 24 cmH2O, which is what was hoped would be achieved, with a relatively modest expiratory positive airway pressure (EPAP), as would be expected from a cohort of patients in whom OSA had been excluded. The median back-up rates were 14 breaths per min (bpm), allowing for good control of hypoventilation during rapid eye movement (REM) sleep.