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Jens Bräunlich,1 Dominic Dellweg,2 Andreas Bastian,3 Stephan Budweiser,4 Winfried Randerath,5 Dora Triché,6 Martin Bachmann,7 Christian Kähler,8 Abdel Hakim Bayarassou,9 Irmhild Mäder,10 Jens Geiseler,11 Norbert Köhler,12 David Petroff,12 Hubert Wirtz11Department of Respiratory Medicine, University of Leipzig AöR, Leipzig, Germany; 2Fachkrankenhaus Kloster Grafschaft GmbH, Schmallenberg Grafschaft, Germany; 3Pneumologie/Intensivmedizin/Infektiologie, Marienkrankenhaus Kassel, Kassel, Germany; 4Medizinische Klinik III, RoMed Klinikum Rosenheim, Rosenheim, Germany; 5Krankenhaus Bethanien gGmbH, Klinik für Pneumologie und Allergologie, Zentrum für Schlaf- und Beatmungsmedizin, Solingen, Germany; 6Department of Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Medical University Nuernberg, General Hospital Nuernberg, Nürnberg, Germany; 7Intensivmedizin und Beatmungsmedizin, Klinik für Atemwegs-, Lungen- und Thoraxmedizin, Asklepios Klinikum Harburg, Hamburg, Germany; 8Department of Internal Medicine, Innsbruck Medical University, Innsbruck, Austria; 9Klinik für Pneumologie, Kardiologie, Schlaf- und Beatmungsmedizin, Malteser Krankenhaus Seliger Gerhard, Bonn/Rhein-Sieg, Bonn, Germany; 10Zentralklinik Bad Berka GmbH, Klinik für Pneumologie, Bad Berka, Germany; 11Medizinische Klinik IV, Klinikum Vest - Paracelsus-Klinik Marl, Marl, Germany; 12Clinical Trial Centre Leipzig, University of Leipzig, Leipzig, GermanyBackground: Despite the encouraging results of noninvasive ventilation (NIV) in chronic hypercapnic COPD patients, it is also evident that some patients do not tolerate NIV or do not benefit from it. We conducted a study in which COPD patients with stable, chronic hypercapnia were treated with NIV and nasal high-flow (NHF) to compare effectiveness.Methods: In a multi-centered, randomized, controlled, cross-over design, patients received 6 weeks of NHF ventilation followed by 6 weeks of NIV ventilation or vice-versa (TIBICO) between 2011 and 2016. COPD patients with stable daytime hypercapnia (pCO2≥50 mmHg) were recruited from 13 German centers. The primary endpoint was pCO2 changes from baseline blood gas, lung function, quality of life (QoL), the 6 min walking test, and duration of device use were secondary endpoints.Results: A total of 102 patients (mean±SD) age 65.3±9.3 years, 61% females, body mass index 23.1±4.8 kg/m,2 90% GOLD D, pCO2 56.5±5.4 mmHg were randomized. PCO2 levels decreased by 4.7% (n=94; full analysis set; 95% CI 1.8–7.5, P=0.002) using NHF and 7.1% (95% CI 4.1–10.1, P

Measurement methods with graded complexity for use in the lab as well as for home sleep testing (HST) are available for the diagnosis of sleep apnea, and there are different classification systems in existence. Simplified HST measurements, which record fewer parameters than traditional four- to six-channel devices, can indicate sleep apnea and can be used as screening tool in high-prevalence patient groups. Peripheral arterial tonometry (PAT) is a technique which can be suitable for the diagnosis of sleep apnea in certain cases. Different measurement methods are used, which has an influence on the significance of the results. New minimal-contact and non-contact technologies of recording and analysis of surrogate parameters are under development. If they are validated by clinical studies, it will be possible to detect sleep apnea in need of treatment more effectively. In addition, this could become a solution to monitor the effectiveness of such treatment., (© 2022. The Author(s), under exclusive license to Springer Nature Switzerland AG.)