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Current Perspectives in Treatment of Obstructive Sleep Apnea: Positive Airway Pressure

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Abstract

Purpose of Review

Sleep apnea is prevalent and associated with increased overall and cardiovascular morbidity and mortality. Positive airway pressure has been the mainstay of treatment for decades, however newer treatments are available. We provide an update on the state of positive airway pressure delivery and its effectiveness compared to other sleep apnea treatments.

Recent Findings

Well-designed prospective cohort studies of sleep apnea have consistently demonstrated morbidity and mortality benefit with positive airway pressure. Randomized controlled trials have not consistently demonstrated such clear benefit, albeit with major limitations related to methodology and exclusion criteria. Positive airway pressure consistently outperforms weight loss, oral appliances, and hypoglossal nerve stimulation in sleep apnea treatment, however pre-treatment bias and discomfort remain barriers to compliance.

Summary

Although advances in medical, surgical and device- related management of sleep apnea show promise, positive airway pressure remains the most effective treatment. Advances in device and mask technology may improve compliance over time.

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Papers of particular interest, published recently, have been highlighted as: •  Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J2-4, Cleveland, OH, 44195, USA

    Anirudh Nandan & Michael D. Faulx

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  1. Anirudh Nandan
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Correspondence to Michael D. Faulx.

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Nandan, A., Faulx, M.D. Current Perspectives in Treatment of Obstructive Sleep Apnea: Positive Airway Pressure. Curr Pulmonol Rep 12, 56–63 (2023). https://doi.org/10.1007/s13665-023-00308-x

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