Research Article Comparison of Auto- and Fixed-Continuous Positive Airway PressureonAirLeakinPatientswithObstructiveSleepApnea: DatafromaRandomizedControlledTrial MariusLebret , 1,2 Marie-Caroline Rotty, 3,4 CyrilArgento, 2 Jean-Louis Pepin, 1,5 Renaud Tamisier , 1,5 FrançoisArbib, 6 DanyJaffuel, 4,7,8 NicolasMolinari, 3,9 andJean-ChristianBorel 1,2,5 1 HP2, INSERM U1042, Grenoble Alpes University, Grenoble, France 2 AGIR ` a dom. Association, Meylan, France 3 IMAG, CNRS, Montpellier University, Montpellier University Hospital, Montpellier, France 4 APARD Groupe Ad`ene, Montpellier, France 5 Sleep Laboratory, orax and Vessels Division, Grenoble Alpes University Hospital, Grenoble, France 6 Cabinet de Pneumologie, ´ Echirolles, France 7 Department of Respiratory Diseases, Montpellier University Hospital, Arnaud de Villeneuve Hospital, Montpellier, France 8 Pulmonary Disorders and Respiratory Sleep Disorders Unit, Polyclinic Saint-Privat, Boujan sur Libron, France 9 Department of Medical Information, Montpellier University Hospital, Montpellier, France Correspondence should be addressed to Marius Lebret; mariuslebret@gmail.com Received 13 April 2019; Revised 23 June 2019; Accepted 10 July 2019; Published 7 August 2019 Academic Editor: Alice M. Turner Copyright © 2019 Marius Lebret et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Auto-CPAP may cause sleep fragmentation due to variations in pressure and unintentional leaks. e aim of this study was to compare air leak between fixed-CPAP and auto-CPAP after 4 months of CPAP treatment. is study is an ancillary analysis of a randomized, double-blind, parallel, controlled trial over 4 months, comparing fixed- and auto-CPAP in newly diagnosed patients with OSA. e following data were extracted from the CPAP devices: mean and 90th percentile pressure, residual apnea-hypopnea index, mean CPAP use, and amount of leak. Within each arm, patients were also randomly allocated to use of one of the three different brands of devices. Since the leak was reported differently for each device, median leak value was determined for each brand and leaks were classified as “above the median” or “below the median”. Data from 269 patients were analyzed. e univariate analysis showed that tobacco consumption, CPAP level, and oronasal masks were associated with leaks above the median value but not the type of CPAP. e multivariate analysis showed that only CPAP level and oronasal masks were associated with leaks below the median. ere were no differences in the types of mask used between fixed- and auto-CPAP. ere was no impact of the type of CPAP on leaks or the type of interface used. We used a method based on the median leak value to standardize comparisons across devices which report leaks with different definitions. 1.Introduction CPAP is the first-line treatment for moderate to severe obstructive sleep apnea (OSA) syndrome [1, 2]. e most frequently reported side effect of CPAP is leaks [3, 4] that cause annoyances such as mouth dryness and nose con- gestion [5, 6]. e etiology of leaks is multifactorial [7], and over the past decades, manufacturers have striven to im- prove interfaces and CPAP algorithms in order to attenuate leaks and reduce mean pressures during sleep. Autoad- justing CPAP is an important technological advancement that adapts the positive pressure applied according to re- sidual obstructive respiratory events (flow limitation or hypopnea/apnea) that are constantly detected by the device. Hindawi Canadian Respiratory Journal Volume 2019, Article ID 6310956, 7 pages https://doi.org/10.1155/2019/6310956