Efficacy and safety of short-term PAP therapy (in automatic mode) in patients with sleep disordered breathing and chronic thromboembolic pulmonary hypertension

Objective. To evaluate short-term APAP therapy safety and efficacy in patients with moderate-to-severe OSA and CTEPH. Material and methods. The study included 67 patients with CTEPH between December 2023 and February 2025. Clinical status, echocardiography and right heart catheterization data were assessed. All patients competed international questionnaires (STOP-Bang, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index) and multifunctional sleep study was performed. In case of moderate-to-severe OSA, we initiated APAP therapy. Results. In 39 patients, we diagnosed moderate-to-severe OSA and offered initiation of in-hospital APAP. Among 30 patients agreed to continue study, 5 ones refused further titration of respiratory support due to inability to sleep, and 25 patients achieved efficacy criteria (residual apnea/hypopnea index <5.0, mean night saturation> 90%) within 1.8±1.2 nights. Supplemental oxygen therapy was required in 5 patients. Safety of APAP therapy was confirmed by daily monitoring. Conclusion. APAP therapy demonstrated a favorable safety and efficacy profile in patients with OSA and CTEPH. Our findings support consideration of APAP therapy as initial treatment option that can improve the quality of medical care.