Comparison With Other Treatments

One of the great advantages of nasal CPAP is that it is immediately and demonstrably efficacious in relieving OSA (2,74). Although that effect is often clinically obvious as early as the CPAP titration night, this beneficial effect of reducing or normalizing the RDI has been convincingly demonstrated in follow-up PSG studies between two weeks and three months after CPAP initiation. This normalization is in contrast to other treatments including sham CPAP, other placebo, conservative management and positional therapy (75-78). Another advantage is that it can be offered on a "trial" basis and withdrawn if not tolerated, in contrast to surgical options. This is particularly important in milder cases of OSA, or where the contribution of OSA to the patient's symptomatology is unclear. A few studies have attempted to compare CPAP with other treatments for OSA using formal protocols. There is a dearth of adequate studies comparing the results of surgical interventions for OSA and those that exist do not support widespread surgical intervention as a satisfactory method of treating OSA (79). The conclusion of most of these studies is that CPAP is the appropriate therapy for patients with moderate-to-severe sleep apnea (80-83). This view is also supported by the 2006 American Academy of Sleep Medicine Standards of Practice Committee Task

Force practice parameters and review of the use of PAP treatment in adults with sleep-disordered breathing (1,84) .

Sleep Apnea

Sleep Apnea

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