Nasal continuous positive airway pressure

The main therapy for obstructive sleep apnea is nasal continuous positive airway pressure (CPAP) therapy because of its effectiveness. 

Nasal continuous positive airway pressure produced improvement. 

Edwards N, Blyton DM, Kirjavainen T, Kesby GJ, Sullivan CE. Nasal continuous positive airway pressure reduces sleep-induced blood pressure increments in preeclampsia. Am J Respir Crit Care Med 2000 162 252-257. 

Krieger J, Meslier N, Lebrun T, et al. Accidents in obstructive sleep apnea patients treated with nasal continuous positive airway pressure a prospective study. The Working Group ANTADIR, Paris and CRESGE, Lille, France. Association Nationale de Traitement a Domicile des Insuffisants Respiratoires. Chest 1997 112 1561-1566. 

Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, Hirano T, Adachi M (2003) Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. 

Black JE, Hirshkowitz M (2005) Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep 28 464-471... 

Verder H, Robertson B, Greisen G, et al. Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. N Engl J Med 1994 331 1051-1055. 

Nonpharmacologic interventions such as weight loss, removing an obstruction in the airway, and or nasal continuous positive airway pressure are considered first-line therapies for obstructive sleep apnea. 

Richards GN, Cistulli PA, Ungar RG, et al. Mouth leak with nasal continuous positive airway pressure increases nasal airway resistance. Am J Respir Crit Care Med 1996 154 182-186. 

Richards GN, Cismlli PA, Ungar RG, et al. Mouth leak with nasal continuous positive airway pressure increases nasal airway resistance. Am J Respir Crit Care Med 1996 154 182-186. Willson GN, Piper AJ, Norman M, et al. Nasal versus full face mask for noninvasive ventilation in chronic respiratory failure. Eur Respir J 2004 23 605-609. 

OHS may present with various possible sleep respiratory patterns (obstructive apneas, hypoventilation, and sometimes, central apneas, or a combined pattern) (7) and needs polysomnographic evaluation to adapt the ventilatory treatment, which is then mandatory (Fig. 3) either as nasal continuous positive airway pressure (nCPAP) or bi-level positive airway pressure ventilation, generally with oxygen supplementation if severe desaturation is present. 

Shivaram U, Cash ME, Beal A. Nasal continuous positive airway pressure in decompensated hypercapnic respiratory failure as a complication of sleep apnea. Chest 1993 104 770-774. Sturani C, Galavotti Y, Scarduelli C, et al. Acute respiratory failure due to severe obstructive sleep apnea syndrome, managed with nasal positive pressure ventilation. Monaldi Arch Chest Dis 1994 49 558-560. 

Pepin JL, Leger P, Veale D, et al. Side effects of nasal continuous positive airway pressure in sleep apnea syndrome study of 193 patients in two French sleep centers. Chest 1995 107 375-381. 

Guilleminauft C, Pelayo R, Clerk A, et al. Home nasal continuous positive airway pressure in infants with sleep-disordered breathing. J Pediatr 1995 127 905-912. 

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