Continuous Positive Airway Pressure (CPAP) has long been considered a standard treatment option for patients with OSA for decades. With CPAP, patients sleep with a mask that forcibly opens the airway and resists the collapse associated with OSA. While the treatment can be very effective when utilized properly it is often felt to be very cumbersome - both for the patient and his/her bed partner [FIGURE 1]. Some patients find the device claustrophobic and disruptive. Others find that using CPAP leads to nasal stuffiness, post-nasal drainage, and congestion. As a consequence, many patients are unable to adhere to a treatment plan with CPAP and remain - in essence - untreated and exposed to all of the health and social risks of OSA. Studies have found that up to 83% of patients become non-adherent to CPAP use. These patients are of particular concern, since some studies have shown that patients intolerant of CPAP have a 10% increased mortality risk at five years when compared to patients with OSA who do adhere to treatment.
Fortunately, the past several years have seen some advancements in Positive Airway Pressure (PAP) technology. Specifically, Auto-titrating machines are now available which continuously respond to airway resistance and auto-adjust the airway pressure delivered. By this continual recalibration, these newer machines may be more effective and efficient than the traditional CPAP mask. Also available are smaller, more comfortable facial pillows which have been designed to make wearing positive airway pressure masks more tolerable.
FIGURE 1 - Patient sleeping with a typical CPAP mask