Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults: A review by the positive airway pressure task force of the Standards of Practice Committee of the American Academy of Sleep Medicine

Peter Gay, Terri Weaver, Daniel Loube, Conrad Iber

Research output: Contribution to journalReview articlepeer-review

406 Scopus citations

Abstract

Positive airway pressure (PAP) is used to treat obstructive sleep apnea (OSA), central sleep apnea (CSA), and chronic hypoventilation. This document provides a systematic analysis and grading of peer-reviewed, published clinical studies pertaining to application of PAP treatment in adults. The paper is divided into 5 sections, each addressing a series of questions. The first section deals with whether efficacy and/or effectiveness have been demonstrated for continuous PAP (CPAP) treatment based on a variety of parameters and the level of OSA severity. Next, CPAP titration conducted with full, attended polysomnography in a sleep laboratory is compared with titration done under various other conditions. The third section investigates what can be expected regarding adherence and compliance with CPAP treatment as measured by subjective and objective methods and what factors may influence these parameters. Side effects and the influence of other specific factors on efficacy, effectiveness and safety of CPAP therapy are evaluated in the fourth section. Finally, the use of bilevel PAP therapy is reviewed for both patients with OSA and those with other selected nocturnal breathing disorders. Each section also contains a brief summary and suggestions for future research.

Original languageEnglish (US)
Pages (from-to)381-401
Number of pages21
JournalSleep
Volume29
Issue number3
DOIs
StatePublished - Mar 1 2006

Keywords

  • Bilevel positive airway pressure, BiPAP
  • CPAP
  • Continuous positive airway pressure
  • Sleep disordered breathing
  • Sleep related breathing disorder, obstructive sleep apnea

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