Treating Sleep Apnea

cpapOnce a patient has been diagnosed with sleep apnea, therapy is prescribed by the primary care physician or sleep specialist. The gold standard therapy for sleep apnea is positive airway pressure (PAP), a term which is often used interchangeably with continuous positive airway pressure (CPAP).

PAP is a noninvasive treatment that uses pressurized room air, supplied by a flow generator, to create a pneumatic splint that keeps the upper airway open and prevents apneas and hypopneas. The pressurized air is delivered to the patient via a mask that fits on/over the nose or nose and mouth. PAP devices and masks are available through home medical equipment (HME) providers.

As a noninvasive and nonpharmaceutical therapy, PAP provides a treatment option free of potential complications and adverse drug reactions. Like all medical treatments, adherence to therapy is critical to achieving therapeutic benefit. Regular follow-up can help patients understand the importance of PAP therapy to their health and well-being.

Different Types of PAP Devices

PAP devices may deliver automatic positive airway pressure (APAP), air pressure that is automatically adjusted to provide the lowest pressure needed to prevent apneas and hypopneas, or variable positive airway pressure (VPAP), also known as bilevel therapy.

Standard CPAP devices deliver a constant pressure that never changes. The challenge is that a person’s pressure needs can vary from night to night, and even from hour to hour. Many factors — sleep position, sleep stage, seasonal allergies, weight gain or loss, use of medications or alcohol — can impact pressure requirements. Hence, the one constant pressure of CPAP may not always be the most comfortable or effective.

APAP — An Intelligent Approach to PAP Treatment

APAP therapy is slightly different than standard CPAP because it uses sophisticated technology to evaluate a user’s breathing and automatically adjust pressure on a breath-by-breath basis based on their real-time pressure needs. ResMed’s APAP solution, also known as AutoSet™, continually monitors and adjusts to a patient’s breathing so they are always receiving optimal pressure.

Why Prescribe APAP?

Patients may find it easier to adjust to APAP. For instance, studies have shown that people using AutoSet were effectively treated while receiving lower average pressures overall and found it easier to adjust to therapy.1-4 By adjusting pressure on a breath-by-breath basis, APAP can help ensure patients are receiving the most effective therapy possible.

Additional AutoSet Comfort Features

AutoSet devices include a number of other features to help improve patient comfort and make therapy a positive, easygoing experience.

  • Expiratory pressure relief (EPR™). EPR lowers pressure incrementally on exhalation so breathing feels more natural.
  • Intelligent humidification with Climate Control. Climate Control combines an intelligent algorithm and heated ClimateLine™ tube to automatically adjust to the temperature and humidity in a patient’s environment to ensure the best humidity level, prevent nasal dryness and reduce condensation in the mask tube.
  • Adjustable Ramp. Designed to make it easier to fall asleep, Ramp lets the user start therapy at a lower pressure which gradually increases over time.
  • Whisper-quiet operation. ResMed’s AutoSet devices have a unique motor that reduces noise to a whisper so as not to disturb the user or their bed partner.

1 Teschler et al. Eur Respir J 2000
2 Hukins. Sleep 2004
3 Resta et al. Monaldi Arch Chest Dis 2004
4 Massie et al. Am J Respir Crit Care Med 2003