LATE BREAKING TOPICS IN RESPIRATORY MEDICINE 2012 

Minerva Pneumologica 2012 June;51(2):73-91

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Continuous positive airway pressure for obstructive sleep apnea syndrome

Piper A. ^{1, 2}

¹ Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia; ² Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, Australia

Obstructive sleep apnea syndrome is a prevalent disorder with significant consequences for the individual and the community. While very effective therapy is available for this condition in the form of continuous positive airway pressure (CPAP), poor acceptance and adherence to treatment by many individuals limits its long term benefits. In response to the discomfort and side effects related to CPAP, a number of design improvements to the devices and interfaces have been made. While these have largely improved therapy-related symptoms, they have had limited impact on adherence to treatment. More recently interest has been directed towards interventions designed to address psychosocial issues related to adherence, and these appear to be more successful. To date most studies evaluating strategies to improve adherence to therapy have not specifically targeted subgroups of patients in whom adherence is likely or confirmed to be problematic. There is a need to better tailor interventions to meet identified needs and evaluate these accordingly. It is also important that future work evaluates the cost-effectiveness of different strategies aimed at improving adherence to therapy. While CPAP remains the mainstay of therapy for OSAS, there is increasing interest in alternative methods of treating this disorder which may be effective for those individuals unwilling or unable to use CPAP. Again, these methods need to be evaluated and long term outcomes compared to those achieved with CPAP.