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Beneficial Effects of Continuous Positive Airway Pressure Therapy

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Dental Sleep Medicine

Abstract

Continuous positive airway pressure (CPAP) treatment has become the standard treatment for obstructive sleep apnea (OSA) introduced in the 1980s. During CPAP therapy, air is applied via a nasal and/or facial mask at a constant increased pressure. This pressure is produced by forcing air through the nose into the pharynx causing a “pneumatic splint,” which prevents the airway from collapsing. Self-adjusting CPAP machines [auto-adjusting positive airway pressure (APAP) and bilevel positive airway pressure (BiPAP)] were developed to treat the pressure to the patient’s needs. Ideally, APAP machine should lead to a reduction in the mean CPAP pressure and associated side effects. It has been demonstrated to resolve sleep disorder breathing and improve several clinical outcomes. The positive airway pressure results in elimination of obstructive apneas, hypopneas, and respiratory effort-related arousals as quantitatively measured by apnea-hypopnea index (AHI) and respiratory distress index (RDI).

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Abbreviations

AHI:

Apnea-hypopnea index

APAP:

Auto-adjusting positive airway pressure

BiPAP:

Bilevel positive airway pressure

CPAP:

Continuous positive airway pressure

CRP:

C-reactive protein

DSAT:

Dental sleep appliance therapy

ESS:

Epworth sleepiness scale

GERD:

Gastroesophageal reflux disorder

IL-6:

Interleukin-6

NIV:

Noninvasive ventilation

OSA:

Obstructive sleep apnea

RDI:

Respiratory disturbance index

References

  1. Strollo PJ Jr, Rogers RM. Obstructive sleep apnea. N Engl J Med. 1996;334:99–104.

    Article  PubMed  Google Scholar 

  2. Ficker JF, Wiest GH, Lehnert G, Wiest B, Hahn EG. Evaluation of an auto-CPAP device for treatment of obstructive sleep apnea. Thorax. 1998;53:643–8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Strohl KP, Redline S. Nasal CPAP therapy, upper airway muscle activation, and obstructive sleep apnea. Am Rev Respir Dis. 1986;134:555–8.

    PubMed  Google Scholar 

  4. American Thoracic Society. Indications and standards for use of nasal continuous positive airway pressure (CPAP) in sleep apnea syndromes. Am J Respir Crit Care Med. 1994;150:1738–45.

    Google Scholar 

  5. Waldhorn RE, Herrick TW, Nguyen MC, et al. Long-term compliance with nasal continuous positive airway pressure therapy of obstructive sleep apnea. Chest. 1990;97:33–8.

    Article  PubMed  Google Scholar 

  6. Hoffstein V, Viner S, Mateika S, Conway J. Treatment of obstructive sleep apnea with nasal continuous positive airway pressure. Patient compliance, perception of benefits, and side effects. Am Rev Respir Dis. 1992;145:841–5.

    Article  PubMed  Google Scholar 

  7. Ficker JH, Müller D, Wiest G, Lehnert G, Dertinger SH, Katalinic A, Hahn EG. Nasal CPAP therapy of obstructive sleep apnea syndrome with expiratory pressure reduction: a prospective randomized study of acceptance of treatment during therapy initiation. Pneumologie. 1997;51:586–91.

    PubMed  Google Scholar 

  8. Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, Redline S, Henry JN, Getsy JE, Dinges DF. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993;147:887–95.

    Article  PubMed  Google Scholar 

  9. Reeves-Hoche MK, Hudgel DW, Meck R, Witteman R, Ross A, Zwillich CW. Continuous versus bilevel positive airway pressure for obstructive sleep apnea. Am J Respir Crit Care Med. 1995;151:443–9.

    Article  PubMed  Google Scholar 

  10. Sanders MH, Gruendl CA, Rogers RM. Patient compliance with nasal CPAP therapy for sleep apnea. Chest. 1986;90:330–3.

    Article  PubMed  Google Scholar 

  11. Polo O, Berthon-Jones M, Douglas NJ, Sullivan CE. Management of obstructive sleep apnea/hypopnea syndrome. Lancet. 1994;344:656–60.

    Article  PubMed  Google Scholar 

  12. Issa FG, Sullivan CE. Upper airway closing pressures in obstructive sleep apnea. J Appl Physiol. 1984;57:520–7.

    Article  PubMed  Google Scholar 

  13. Meurice JC, Marc I, Series F. Efficacy of auto-CPAP in the treatment of obstructive sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1996;153:794–8.

    Article  PubMed  Google Scholar 

  14. Series F, Marc I, Cormier Y, La Forge J. Required levels of nasal continuous positive airway pressure during treatment of obstructive sleep apnea. Eur Respir J. 1994;7:1776–81.

    Article  PubMed  Google Scholar 

  15. Grunstein RR. Sleep-related breathing disorders. 5. Nasal continuous positive airway pressure treatment for obstructive sleep apnea. Thorax. 1995;50:1106–13.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sharples L, Glover M, Clutterbuck-James A, Bennett M, Jordan J, Chadwick R, Pittman M, East C, Cameron M, Davies M, Oscroft N, Smith I, Morrell M, Fox-Rushby J, Quinnell T. Clinical effectiveness and cost-effectiveness results from the randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnea-hypopnea (TOMADO) and long-term economic analysis of oral devices and continuous positive airway pressure. Health Technol Assess. 2014;18(67):1–296.

    Article  PubMed  PubMed Central  Google Scholar 

  17. AHRQ. AHRQ comparative effectiveness review, vol. 32. Rockville: AHRQ; 2011.

    Google Scholar 

  18. Giles TL, Lasserson TJ, Smith BH, White J, Wright J, Cates CJ. Continuous positive airways pressure for obstructive sleep apnea in adults. Cochrane Database Syst Rev. 2006;3:CD001106.

    Google Scholar 

  19. Campos-Rodriguez F, Queipo-Corona C, Carmona-Bernal C, et al. Continuous positive airway pressure improves quality of life in women with obstructive sleep apnea. A randomized controlled trial. Am J Respir Crit Care Med. 2016;194(10):1286.

    Article  PubMed  Google Scholar 

  20. Tomfohr LM, Ancoli-Israel S, Loredo JS, Dimsdale JE. Effects of continuous positive airway pressure on fatigue and sleepiness in patients with obstructive sleep apnea: data from a randomized controlled trial. Sleep. 2011;34(1):121.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pan YY, Deng Y, Xu X, Liu YP, Liu HG. Effects of continuous positive airway pressure on cognitive deficits in middle-aged patients with obstructive sleep apnea syndrome: a meta-analysis of randomized controlled trials. Chin Med J (Engl). 2015;128(17):2365.

    Article  Google Scholar 

  22. Marshall NS, Barnes M, Travier N, Campbell AJ, Pierce RJ, RD ME, Neill AM, Gander PH. Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnea: a meta-analysis. Thorax. 2006;61(5):430.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Barbé F, Mayoralas D, Masa JF, et al. Treatment with continuous positive airway pressure is not effective in patients with sleep apnea but no daytime sleepiness. A randomized, controlled trial. Ann Intern Med. 2001;134(11):1015–23.

    Article  PubMed  Google Scholar 

  24. Tregear S, Reston J, Schoelles K, Phillips B. Continuous positive airway pressure reduces risk of motor vehicle crash among drivers with obstructive sleep apnea: systematic review and meta-analysis. Sleep. 2010;33(10):1373–80.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Parish JM, Lyng PJ. Quality of life in bed partners of patients with obstructive sleep apnea or hypopnea after treatment with continuous positive airway pressure. Chest. 2003;124(3):942–7.

    Article  PubMed  Google Scholar 

  26. Egea CJ, Aizpuru F, Pinto JA, Ayuela JM, et al. Cardiac function after CPAP therapy in patients with chronic heart failure and sleep apnea: a multicenter study. Sleep Med. 2008;9(6):660–6.

    Article  PubMed  Google Scholar 

  27. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2018;71(19):e127–248.

    Article  PubMed  Google Scholar 

  28. Bratton DJ, Gaisl T, Wons AM, Kohler M. CPAP vs mandibular advancement devices and blood pressure in patients with obstructive sleep apnea: a systematic review and meta-analysis JAMA 2015;314(21):2280–2293.

    Article  PubMed  Google Scholar 

  29. McEvoy RD, Antic NA, Heeley E, Luo Y, Ou Q, et al. CPAP for prevention of cardiovascular events in obstructive sleep apnea. N Engl J Med. 2016;375(10):919–31.

    Article  PubMed  Google Scholar 

  30. Brill AK, Horvath T, Seiler A, Camilo M, Haynes AG, Ott SR, Egger M, Bassetti CL. CPAP as treatment of sleep apnea after stroke: a meta-analysis of randomized trials. Neurology. 2018;90(14):e1222–30.

    Article  PubMed  Google Scholar 

  31. Ryan CM, Bayley M, Green R, Murray BJ, Bradley TD. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea. Stroke 2011;42(4):1062–1067.

    Article  PubMed  Google Scholar 

  32. Martínez-García MA, Soler-Cataluña JJ, Ejarque-Martínez L, Soriano Y, et al. Continuous positive airway pressure treatment reduces mortality in patients with ischemic stroke and obstructive sleep apnea: a 5-year follow-up study. Am J Respir Crit Care Med. 2009;180(1):36–41.

    Article  PubMed  Google Scholar 

  33. Martínez-García MA, Galiano-Blancart R, Román-Sánchez P, Soler-Cataluña JJ, Cabero-Salt L, Salcedo-Maiques E. Continuous positive airway pressure treatment in sleep apnea prevents new vascular events after ischemic stroke. Chest. 2005;128(4):2123–9.

    Article  PubMed  Google Scholar 

  34. Egea CJ, Aizpuru F, Pinto JA, Ayuela JM, Ballester E, et al. Cardiac function after CPAP therapy in patients with chronic heart failure and sleep apnea: a multicenter study. Sleep Med. 2008;9(6):660–6.

    Article  PubMed  Google Scholar 

  35. Kaneko Y, Floras JS, Usui K, Plante J, Tkacova R, Kubo T, Ando SI, Bradley TD. Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea. N Engl J Med. 2003;348(13):1233–41.

    Article  PubMed  Google Scholar 

  36. Khayat RN, Abraham WT, Patt B, Pu M, Jarjoura D. In-hospital treatment of obstructive sleep apnea during decompensation of heart failure. Chest. 2009;136(4):991–7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Khayat RN, Abraham WT, Patt B, Roy M, Hua K, Jarjoura D. Cardiac effects of continuous and bilevel positive airway pressure for patients with heart failure and obstructive sleep apnea: a pilot study. Chest. 2008;134(6):1162–8.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. UC Davis School of Medicine and SJGH, Sacramento, CA, USA

    Deepak Shrivastava

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  1. Deepak Shrivastava
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Correspondence to Deepak Shrivastava .

Editor information

Editors and Affiliations

  1. Center For TMJ & Sleep Therapy, Glendora, CA, USA

    G. Gary Demerjian

  2. Craniofacial Pain & Dental Sleep Center, Atlanta, GA, USA

    Mayoor Patel

  3. Dental Group of Sherman Oaks, Los Angeles, CA, USA

    Francesco Chiappelli

  4. Department of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, CA, USA

    André Barkhordarian

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Shrivastava, D. (2022). Beneficial Effects of Continuous Positive Airway Pressure Therapy. In: Demerjian, G.G., Patel, M., Chiappelli, F., Barkhordarian, A. (eds) Dental Sleep Medicine. Springer, Cham. https://doi.org/10.1007/978-3-031-10646-0_9

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  • DOI: https://doi.org/10.1007/978-3-031-10646-0_9

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  • Online ISBN: 978-3-031-10646-0

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