IOS Parameters and PAP Titration Pressure in Obstructive Sleep Apnea (IOS-PAP)

Impulse Oscillometry for Prediction of PAP Titration Pressure in Obstructive Sleep Apnea (IOS-PAP Study)

This prospective observational study aims to investigate whether impulse oscillometry (IOS)-a non-invasive lung function test-can help predict the specific pressure settings needed for positive airway pressure (PAP) therapy in patients with obstructive sleep apnea (OSA).

Currently, finding the optimal therapeutic pressure for OSA patients typically requires a titration process during sleep. This study explores if IOS parameters, which measure airway resistance and elasticity through small pressure oscillations during normal breathing, correlate with the final titration pressures (CPAP, EPAP, IPAP, and ΔP) determined by polysomnography.

Adult patients diagnosed with moderate-to-severe OSA (Apnea-Hypopnea Index ≥ 15) will undergo standard diagnostic sleep testing followed by IOS testing using the Vyaire Vyntus BodyBox® system. The researchers will evaluate whether these respiratory measurements can accurately predict required airway pressures and if they can help clinicians distinguish between patients who need Continuous Positive Airway Pressure (CPAP) versus Bilevel Positive Airway Pressure (BPAP) therapy.

Study Overview

• Status: Not yet recruiting
• Conditions: Obstructive Sleep Apnea (OSA)

• Study Type: Observational
• Enrollment (Estimated): 92

Contacts and Locations

• Study Contact: Name: Kadir Burak Akgün, Assistant Professor; Phone Number: +905448127828; Email: kadirburakakgun@gmail.com

Study Locations

• Turkey (Türkiye)
  • Hatay
    • Antakya, Hatay, Turkey (Türkiye), 31001
      • Hatay Mustafa Kemal University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adults with moderate-to-severe obstructive sleep apnea (OSA) undergoing PAP titration and IOS testing at Hatay Mustafa Kemal University.

Description

Inclusion Criteria:

• Adults aged 18 to 80 years
• Diagnosed with obstructive sleep apnea (OSA) by overnight polysomnography (PSG)
• Apnea-hypopnea index (AHI) ≥ 15
• Undergoing positive airway pressure (PAP) titration (CPAP or BPAP)
• Able to perform impulse oscillometry (IOS) test
• Provided written informed consent

Exclusion Criteria:

• Central sleep apnea
• Neuromuscular disease or restrictive lung disease
• Recent upper airway infection (< 2 weeks)
• Incomplete PSG or IOS data
• Inability to cooperate with testing procedures

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Moderate-to-Severe OSA Patients; Adult patients newly diagnosed with moderate-to-severe obstructive sleep apnea (AHI ≥ 15) who are scheduled to undergo an overnight PAP titration polysomnography. All participants in this single cohort will receive baseline impulse oscillometry (IOS) testing prior to their sleep study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation between baseline impulse oscillometry (IOS) parameters (R5, X5, and Fres) and optimal CPAP pressure.	Evaluating the relationship between specific lung function parameters-specifically total airway resistance (R5), reactance (X5), and resonant frequency (Fres)-measured by a daytime IOS session, and the effective Continuous Positive Airway Pressure (CPAP) determined during the subsequent overnight titration study.	From baseline IOS measurement to completion of the overnight titration study (assessed up to 4 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Discriminative ability of IOS parameters for CPAP versus BPAP treatment allocation.	Assessing whether baseline impulse oscillometry parameters (R5, X5, Fres, AX) can predict if a patient will require Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BPAP) therapy. This will be evaluated using the Area Under the Receiver Operating Characteristic (ROC) Curve.	From baseline IOS measurement to completion of the overnight titration study (assessed up to 4 weeks).
Correlation between baseline IOS reactance parameters and bilevel pressure settings (IPAP/EPAP).	Assessing whether baseline impulse oscillometry parameters can predict the specific Inspiratory Positive Airway Pressure (IPAP) and Expiratory Positive Airway Pressure (EPAP) levels required for Bilevel Positive Airway Pressure (BPAP) therapy. This will be evaluated using the correlation coefficient.	From baseline IOS measurement to completion of the overnight titration study (assessed up to 4 weeks).

Collaborators and Investigators

• Sponsor: Mustafa Kemal University

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): November 30, 2026
• Study Completion (Estimated): January 2, 2027

Study Registration Dates

• First Submitted: April 21, 2026
• First Submitted That Met QC Criteria: April 21, 2026
• First Posted (Actual): April 28, 2026

Study Record Updates

• Last Update Posted (Actual): April 28, 2026
• Last Update Submitted That Met QC Criteria: April 21, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: obstructive sleep apnea; positive airway pressure; cpap; bpap
• Additional Relevant MeSH Terms: Nervous System Diseases; Respiratory Tract Diseases; Respiration Disorders; Sleep Wake Disorders; Apnea; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Microcephaly, Primary Autosomal Recessive, 6
• Other Study ID Numbers: HMKU-25A002-IOS-PAP; BAP Project No: 25.A.002 (Other Identifier: Hatay Mustafa Kemal University Scientific Research Projects Coordination Unit)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No