Positive Airway Pressure Treatment for Obstructive Sleep Apnea
Abstract
Positive airway pressure (PAP) is the treatment of choice for patients with moderate-to-severe obstructive sleep apnea (OSA). Randomized controlled trials have demonstrated that PAP can effectively reduce the apnea-hypopnea index and improve subjective and objective sleepiness. Some studies have also demonstrated benefits in sleep quality and quality of life for both the patient and bed partner. Observational studies have shown a reduction in the risk of cardiovascular events in OSA patients treated with PAP compared to untreated patients. Since continuous PAP (CPAP) treatment of OSA was described, additional modes of pressure delivery have been developed (bilevel PAP, autoadjusting PAP, flexible PAP). While none of the variants of PAP improves adherence in unselected patients compared to CPAP, individual patients may respond to a change in pressure mode. Attended PAP titration remains the standard of practice for selecting a treatment pressure. However, use of autotitrating PAP devices in the unattended setting can provide an effective titration alternative with careful patient selection and review of titration results. More choices of mask interface are now available to improve comfort and intervene for mask or mouth leaks. However, despite the increase in PAP treatment options, lack of acceptance and inadequate adherence to PAP therapy remain the major causes of treatment failure. Some studies suggest that heated humidification can improve PAP adherence, especially in pati…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Treatment of OSA improves quality of life.
“The treatment of OSA has been shown to improve QOL, lower the rates of motor vehicle accidents, and reduce the risk of the chronic health consequences of untreated OSA mentioned above.19”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [19]
Treatment of OSA reduces risk of chronic health consequences of untreated OSA.
“The treatment of OSA has been shown to improve QOL, lower the rates of motor vehicle accidents, and reduce the risk of the chronic health consequences of untreated OSA mentioned above.19”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [19]
Treatment of OSA lowers rates of motor vehicle accidents.
“The treatment of OSA has been shown to improve QOL, lower the rates of motor vehicle accidents, and reduce the risk of the chronic health consequences of untreated OSA mentioned above.19”
From Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline (2017) · cites this paper as [19]
Cites
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678 · see citing works
Patient Adherence and Medical Treatment Outcomes: A Meta-Analysis
Robin DiMatteo, M., Giordani, P. J., Lepper, H. S., & Croghan, T. W. (2002) · Medical Care · doi:10.1097/00005650-200209000-00009 · Cited by 1,490 · see citing works
Obstructive Sleep Apnea and the Recurrence of Atrial Fibrillation
Kanagala, R., Murali, N. S., Friedman, P. A., Ammash, N. M., Gersh, B. J., Ballman, K. V., M. Shamsuzzaman, A. S., & Somers, V. K. (2003) · Circulation · doi:10.1161/01.cir.0000068337.25994.21 · Cited by 983 · see citing works
Long-term Use of CPAP Therapy for Sleep Apnea/Hypopnea Syndrome
McARDLE, N., DEVEREUX, G., HEIDARNEJAD, H., ENGLEMAN, H. M., MACKAY, T. W., & DOUGLAS, N. J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.4.9807111 · Cited by 820 · see citing works
Babu, A. R., Herdegen, J., Fogelfeld, L., Shott, S., & Mazzone, T. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.4.447 · Cited by 453 · see citing works
A Randomized Controlled Trial of Continuous Positive Airway Pressure in Mild Obstructive Sleep Apnea
Barnes, M., Houston, D., Worsnop, C. J., Neill, A. M., Mykytyn, I. J., Kay, A., Trinder, J., Saunders, N. A., McEvoy, R. D., & Pierce, R. J. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.6.2003166 · Cited by 329 · see citing works
Massie, C. A., Hart, R. W., Peralez, K., & Richards, G. N. (1999) · Chest · doi:10.1378/chest.116.2.403 · Cited by 308 · see citing works
Engleman, H. M., McDonald, J. P., Graham, D., Lello, G. E., Kingshott, R. N., Coleman, E. L., Mackay, T. W., & Douglas, N. J. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2109023 · Cited by 289 · see citing works
Sajkov, D., Wang, T., Saunders, N. A., Bune, A. J., & Douglas Mcevoy, R. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.2.2010092 · Cited by 266 · see citing works
Compliance With Nasal CPAP Can Be Improved by Simple Interventions
Chervin, R. D., Theut, S., Bassetti, C., & Aldrich, M. S. (1997) · Sleep · doi:10.1093/sleep/20.4.284 · Cited by 242 · see citing works
Lung Volume and Continuous Positive Airway Pressure Requirements in Obstructive Sleep Apnea
Heinzer, R. C., Stanchina, M. L., Malhotra, A., Fogel, R. B., Patel, S. R., Jordan, A. S., Schory, K., & White, D. P. (2005) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200404-552oc · Cited by 219 · see citing works
Harsch, I. A., Schahin, S. P., Brückner, K., Radespiel-Tröger, M., Fuchs, F. S., Hahn, E. G., Konturek, P. C., Lohmann, T., & Ficker, J. H. (2004) · Respiration · doi:10.1159/000077423 · Cited by 219 · see citing works
Woodson, B. T., Steward, D. L., Weaver, E. M., & Javaheri, S. (2003) · Otolaryngology - Head and Neck Surgery · doi:10.1016/s0194-5998(03)00461-3 · Cited by 165 · see citing works
Hukins, C. (2004) · Sleep · doi:10.1093/sleep/27.8.1512 · Cited by 100 · see citing works
Humidified nasal continuous positive airway pressure in obstructive sleep apnoea
Neill, A. M., Wai, H. S., Bannan, S. P. T., Beasley, C. R., Weatherall, M., & Campbell, A. J. (2003) · European Respiratory Journal · doi:10.1183/09031936.03.00035603 · Cited by 97 · see citing works
Oral Continuous Positive Airway Pressure for Sleep Apnea
Beecroft, J., Zanon, S., Lukic, D., & Hanly, P. (2003) · Chest · doi:10.1378/chest.124.6.2200 · Cited by 87 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6506 · Cited by 3,253 · see citing works
Meschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650 · see citing works
Apnea medassist: Real-time sleep apnea monitor using single-lead ECG
Bsoul, M., Minn, H., & Tamil, L. (2011) · IEEE Transactions on Information Technology in Biomedicine · doi:10.1109/titb.2010.2087386 · Cited by 297 · see citing works
Winslow, D. H., Bowden, C. H., DiDonato, K. P., & McCullough, P. A. (2012) · Sleep · doi:10.5665/sleep.2204 · Cited by 163 · see citing works
Obstructive sleep apnea: role in the risk and severity of diabetes
Pamidi, S., Aronsohn, R. S., & Tasali, E. (2010) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2010.08.009 · Cited by 121 · see citing works
CPAP compliance in patients with obstructive sleep apnea syndrome
Yetkin, O., Kunter, E., & Gunen, H. (2008) · Sleep And Breathing · doi:10.1007/s11325-008-0188-4 · Cited by 102 · see citing works
Nakashima, H., Kurobe, M., Minami, K., Furudono, S., Uchida, Y., Amenomori, K., Nunohiro, T., Takeshita, S., & Maemura, K. (2015) · European Heart Journal: Acute Cardiovascular Care · doi:10.1177/2048872614530865 · Cited by 71 · see citing works
CPAP interface: satisfaction and side effects
Bachour, A., Vitikainen, P., Virkkula, P., & Maasilta, P. (2013) · Sleep and Breathing · doi:10.1007/s11325-012-0740-0 · Cited by 68 · see citing works
RYAN, S., GARVEY, J. F., SWAN, V., BEHAN, R., & MCNICHOLAS, W. T. (2011) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2010.00873.x · Cited by 56 · see citing works
Rates of initial acceptance of PAP masks and outcomes of mask switching
Bachour, A., Vitikainen, P., & Maasilta, P. (2016) · Sleep and Breathing · doi:10.1007/s11325-015-1292-x · Cited by 48 · see citing works
Nasal Obstruction Considerations in Sleep Apnea
Awad, M. I., & Kacker, A. (2018) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2018.05.012 · Cited by 41 · see citing works
Hobson, J. C., Robinson, S., Antic, N. A., McEvoy, R. D., Windler, S., MacKay, S., & Carney, A. S. (2012) · The Laryngoscope · doi:10.1002/lary.23342 · Cited by 40 · see citing works
Meng, L. (2010) · Obesity Surgery · doi:10.1007/s11695-008-9741-2 · Cited by 25 · see citing works
- Authors
- Kakkar, R. K., & Berry, R. B.
- Affiliations
- Malcom Randall VA Medical Center (US)
- University of Florida (US)
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2007-09
- Volume
- 132
- Issue
- 3
- Pages
- 1057-1072
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2070050199
- Cited by
- 258
- References
- 16
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 15 · 2023: 12 · 2022: 9 · 2021: 13 · 2020: 16 · 2019: 8 · 2018: 12 · 2017: 13 · 2016: 17 · 2015: 15 · 2014: 17 · 2013: 21 · 2012: 12
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Keywords
- positive airway pressure, obstructive sleep apnea, continuous positive airway pressure, medication adherence, heated humidification, apnea-hypopnea index, sleepiness, cardiovascular risk, quality of life, patient education
- MeSH terms
- Humans, Masks, Patient Compliance, Positive-Pressure Respiration, Sleep Apnea, Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
