AutoVPAP Versus VPAP; Assessment of Sleep and Ventilation

Crossover Trial of VPAP (Variable Positive Airway Pressure) Ventilation Versus AutoVPAP in Neuromuscular and Chest Wall Disease: Effects on Nocturnal Hypoventilation, Sleep Quality and Tolerance

The aim of the study is to compare the effects of a modified form (AutoVPAP) of the VPAP non-invasive ventilator versus standard VPAP ventilation on sleep quality and breathing during sleep in stable patients with nocturnal hypoventilation due to restrictive ventilatory disorders (eg. neuromuscular disease or chest wall disorder).

Inclusion Criteria:

• Patients aged 18-80 years
• Nocturnal hypoventilation (nocturnal peak transcutaneous PCO2 > 6.5 kPa when breathing spontaneously) with
• Congenital neuromuscular disease (eg. Duchenne muscular dystrophy, congenital muscular dystrophy), acquired neuromuscular disease (eg. old polio, bilateral diaphragm paralysis) or chest wall disease (eg. idiopathic scoliosis, thoracoplasty)
• Recruited from 1300 patients attending Royal Brompton Hospital Lind ward ventilator clinic.
• All patients will be familiar with non-invasive ventilation use but currently using a ventilator which is not a VPAP model eg. BiPAP Harmony, Breas PV403.
• Able to understand treatment and protocol

Exclusion Criteria:

• Unstable respiratory failure (PaO2 < 7.5 kPa, PaCO2 > 8.0 kPa,
• Uncontrolled heart failure or arrhythmia
• Moderate or severe bulbar weakness.
• Unable to understand treatment or protocol