Introduction: Dream Station CPAP A-Trial mode (Philips Respironics Inc, Murrysville, PA) allows auto-titrating patients at home for a selected period of time and then set automatically the optimal pressure.

Objectives: The purpose of this study was to demonstrate that initiating CPAP treatment with a Dream Station CPAP set in A-Trial mode had no difference with conventional autoCPAP titration for adherence and clinical outcomes.

Methods: Control group started CPAP with an empiric pressure of 7cmH2O during a month, after one-night AutoCPAP titration at home, the optimal pressure was manually fixed. The intervention group used A-Trial mode during ten nights and after that, the optimal pressure was automatically set. Follow-up was one year and we collected data of ESS, adherence based on the hours of CPAP use and residual apnea hipopnea index (AHI), both registered by the home CPAP device.

Results: Fifty moderate to severe OSA patients were recruited and finally 37 individuals were analyzed, 17 in the control group and 21 in the A-Trial group. Both groups significantly improved symptoms measured by ESS [ESS pre-treatment 14.13 (± 7.06) vs 12.81 (± 6.05) and ESS post-treatment 10.06 (± 6.9) p=0.001 vs 9.52 (± 4.62) p=0.004] but there were no differences at the end of the study (p=0.494). After one year of follow-up there were no statistically differences in adherence althought clinically relevants 53.3% vs 71.4% (p=0.265) in control and A-Trial group, respectively. The final fixed pressure was similar in control and treatment group [mean 8.16 (± 1.7) vs 8.55 (± 1.49) p=0.287.

Conclusions: Initiating A-Trial CPAP mode is as effective as home CPAP titration with AutoCPAP.