CPAP - Continuous Positive Airway Pressure

The most commonly prescribed method of treatment for obstructive sleep apnea is continuous positive airway pressure or CPAP. A CPAP machine delivers air pressure of adjustable intensity through a nasal mask worn during sleep.

Nasal CPAP is a well-established treatment that many people adapt to quickly; however, new research shows a failure rate of 40-60% for CPAP. 1

There are 3 types of CPAP devices:

  1. Standard CPAP - Standard CPAP delivers a fixed pressure of room air. The air pressure forms a "splint" preventing the airway from collapsing during sleep. The pressure used is determined during a CPAP titration study.
  2. Bi-level CPAP - Bi-level devices use two different pressures to support the airway - a stronger pressure is delivered during inhalation and a lower pressure is used during exhalation. The change in pressure is determined by the patient's breathing pattern.
  3. Smart CPAP - Smart PAP machines automatically adjust the pressure in response to a patient's needs throughout the night.

 

Possible Side effects of CPAP treatment include: 4

  • Nasal Congestion
  • Conjunctivitis
  • Sinus Involvement
  • Skin Irritation
  • Gastric Distension - bloating
  • Allergic Reaction
  • Nasal Bleeding
  • Claustrophobia
  • Hearing Loss 3

 

Residual sleep apnea s common in moderate to severa OSA and is associated with worse outcomes. 2

Sources

1. Philips, Grunstein, Cistulli. Health Outcomes CPAP. AM. J. Resp. + Crit. Care Med 2013 Vol 187.

2. Mulgrew, Ayas, Ryan. Sleep Med 2010

3. McCormick, Worley. The Oehsner Journal 2016

4. Virk, Kotecha. J. Thoracic Disease 2016