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Positive Airway Pressure in the Treatment of Sleep Apnea–Hypopnea

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Sleep Disorders Medicine

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Abstract

The application of nasal continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea in adults was first described in 1981. Since then, it has become the medical therapy of choice for obstructive sleep apnea (OSA). Fundamentally, conventional positive airway pressure (PAP) systems that are employed to treat OSA patients consist of a generator that directs airflow downstream to the patient via tubing and an interface (e.g., nasal mask, oral-nasal mask, nasal cannula or prongs, or oral interface). Air, under the clinician-prescribed degree of positive pressure, is then introduced into the upper airway. The air pressure pneumatically splints the upper airway, thereby maintaining patency of this conduit and minimizing resistance to airflow. The splinting effect constitutes the primary mechanism of therapeutic action. An additional mechanism of action is the direct relationship between lung volume and upper airway patency mediated through traction on mediastinal and upper airway structures created during lung inflation; it has been postulated that at least part of the effect of CPAP in maintaining upper airway patency is mediated through augmentation of lung volume, although the magnitude of the effect is relatively small.

Charles W. Atwood Jr., MD, has received research grants from ResMed, Philips-Respironics and Vapotherm. He is an advisor to Philips-Respironics and Vapotherm.

Patrick J. Strollo Jr., MD, has received research grants from ResMed, Philips-Respironics, Inc., and the National Football League.

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  1. Division of Pulmonary, Allergy and Critical Care Medicine, UPMC Sleep Medicine Center, VA Pittsburgh Healthcare System, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Charles W. Atwood & Patrick J. Strollo

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    Sudhansu Chokroverty

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Atwood, C.W., Strollo, P.J. (2017). Positive Airway Pressure in the Treatment of Sleep Apnea–Hypopnea. In: Chokroverty, S. (eds) Sleep Disorders Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6578-6_34

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