Treatment of obstructive sleep apnea with positive pressure ventilation

Abstract

Continuous positive airway pressure (CPAP) is the gold-standard treatment for moderate to severe obstructive sleep apnea (OSA). Before CPAP therapy, optimal pressure to relieve any airway obstructive events (apnea, hypopnea, respiratory effort-related arousals, and snoring) should be measured during the second polysomnography. The main benefits of CPAP use are 1) elimination of airway obstructions regardless of sleep stages and positions during sleep, 2) amelioration of daytime and nocturnal symptoms, 3) decreased incidence and progression of systemic co-morbidities such as cardiovascular diseases, and 4) decreased incidence of accident-related traumas and mortality related to somnolence caused by OSA. Although CPAP is the most reliable and effective treatment for OSA, lack of patient acceptance and compliance may limit the CPAP use. To solve these problems, it is very important to educate patients and manage complications associated with mask and pressure-related discomforts as early as possible.