P005 A two-night randomised controlled cross-over trial of AVAPS AE auto-titrating bi-level ventilation vs standard in-lab titration in patients with motor neurone disease commencing overnight ventilatory support

Abstract Introduction Sleep disordered breathing in motor neurone disease (MND) is heterogeneous. Auto-adjusting AVAPS-AE mode of non-invasive ventilation (NIV) could simplify NIV setup and use MND. This pilot study assessed titration longer-term outcomes with AVAPS AE auto-pressure support versus standard S/T patients Methods 10 MND commencing consented to a 2 consecutive night randomised controlled cross-over trial auto-titrating titrated according current clinical practice. Patients underwent in-laboratory polysomnography (PSG) on both nights before continuing the second allocated NIV. Results 8 completed 9 subsequently continued home (4 5 mode). Compared baseline, modes significantly reduced apnea hypopnea index (AHI; mean [95%CI] 14.8 [6.8-22.8] 1.2 [0-2.7] 3.6 [0-7.1] /h respectively), no significant differences between other PSG outcomes. Maximum EPAP (15.4 [13.4-17.4] vs 8.3 [4.9-11.6] cmH2O, p=0.003) pressure levels (16.3 [11.2-21.3] 6.6 [5.9-7.4] were higher respectively, although average not different. Over 6 months follow-up, daily was similar treatment groups (AVAPS-AE 7.3 [3.2-11.3]; 7.8 [3.5-12] h/day). Conclusion Automated BiPAP appears achieve control sleep when compared mode, be well tolerated used