OBJECTIVES: Obstructive sleep apnea (OSA) is a sleep disorder with repeated nocturnal desaturation and sleep fragmentation. It can lead to poor quality of life. Our goal was to compare improvement in the quality of life of patients with OSA between those treated with continuous positive airway pressure (CPAP) and autotitrating positive airway pressure (APAP) for 3 months. MATERIALS AND METHODS: This was a prospective, randomized, crossover study. Study participants were patients with OSA randomized into the APAP or CPAP group, with crossover to the other group 3 months later. All patients received CPAP or APAP treatment for > 4 h/d. Each patient completed the Short Form 36 Health Survey (SF-36) before and after the 3-month CPAP and APAP treatment. RESULTS: The 19 patients had severe OSA (mean apnea-hypopnea index (AHI) 59.7 +/- 23.9 /h) and the mean optimal pressure of CPAP titration was 8.7 +/- 1.5 mmHg. The CPAP group had a higher mean pressure 8.7 +/- 1.4 mmHg as well as a lower AHI 0.6 +/- 1.4 /h than the APAP group. There was no difference in compliance between groups. Both groups had significant improvement in general health and vitality after treatment compared with before treatment. However, there were no significant differences in improvement in any component of the SF-36 between groups. CONCLUSION: In our study, the CPAP patients had a higher pressure and lower AHI than the APAP patients. OSA patients preferred APAP. Both CPAP and APAP can improve general health and vitality in OSA patients.

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