Treatment-emergent central sleep apnea resolves with lower inspiratory pressure.

Study Objectives: Treatment emergent central sleep apnea (TECSA) is an important problem during therapy with continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA). Here we tested a device designed to improve CPAP comfort through reducing IPAP (-Com) to determine if such a reduction in IPAP could eliminate central apneas in patients with TECSA. Since increasing tidal volume (potentially via IPAP increments) has been suggested as a possible mechanism contributing to TECSA onset, our hypothesis was that reducing IPAP would yield a drop in the central apnea index (CAI).

Kairos positive airway pressure (KPAP) equals continuous PAP in effectiveness, and offers superior comfort for obstructive sleep apnea treatment.

Study Objectives: A recent study challenged the prevailing clinical view that maintaining inspiratory positive airway pressure (IPAP) is necessary for upper airway patency, demonstrating no differences in apnea hypopnea index (AHI) between continuous PAP (CPAP) with and without a resistor to reduce IPAP. In this study, we assessed the effect of Kairos PAP (KPAP), a new algorithm which features multiple drops in IPAP, only returning to therapeutic pressure near the end expiration, on sleep apnea severity and subjective comfort.

Methods: Two randomized clinical trials were conducted.

Circuit-dependent carbon dioxide rebreathing during continuous positive airway pressure.

Background: The current standard treatment for obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP), is characterized by a low adherence rate due to various factors including circuit-dependent carbon dioxide (CO) rebreathing, which can exacerbated by disparate factors, such as low PAP, use of auto-titrating PAP or ramps. However, risk factors for rebreathing are often overlooked or poorly understood in clinical practice. Therefore, our objective was to evaluate the extent of rebreathing occurring with commonly used CPAP masks across varying PAPs, tidal volumes, and respiratory rates.

Positive airway pressure therapy supplied by an integrated sleep practice associated with greater adherence among pre-Medicare-aged patients with sleep-disordered breathing.

Study Objectives: We investigated whether patient adherence to positive airway pressure (PAP) therapy was significantly different between groups whose PAP machines were dispensed by a traditional durable medical equipment (DME) supplier (DME group) versus those provided directly by an integrated sleep practice (ISP group).

Methods: This was a retrospective cohort study that analyzed 3884 patients (ages 18-64) who were set up with a new PAP machine for sleep-disordered breathing. The channel through which PAP therapy was dispensed (DME vs ISP) was chosen as part of the natural course of treatment, making patient choice and third-party payor likely important selection factors.