Nasal CPAP

(Do not forget weight reduction)

The use of nasal CPAP (Sullivan et al 1981) was a major advance in the management of obstructive sleep apnea. Initially the CPAP machines were off-the-shelf compressors adapted for medical use (see document).
Since then an entire industry has developed with many choices available.

However these points should be kept in mind:

  • There is no significant difference between one brand and another (they are all effective).
  • There is no real advantage in more sophisticated CPAP machines (they simply cost more!!).
  • For patients who have major difficulty breathing out, the use of CPAP with the option of lowering the pressure while breathing out (e.g. ResMed Autoscore 8™, and Respironic C-Flex ™) may be useful.
  • When the pressure is high (> 9 cm) the use of a humidification with the CPAP is also useful.
  • The use of chin strap (to keep the mouth closed) is only indicated in patient with neuromuscular diseases, hardly ever otherwise (despite their wide use and recommendation).

Approximately 20-25 % of patients who would benefit from nasal CPAP have great difficulty tolerating.

For more information download this Nasal CPAP document.