Rethinking what an effective treatment for obstructive sleep apnea means


Sleep Treatments | Sleep Review

Focusing on overall breathing events during the night and quality of life during the day can provide a clearer picture of how well oral appliances compare to CPAP in patients with mild to moderate obstructive sleep apnea.

From Lisa Rapaport

In a tightly controlled setting – like a sleep disorder center for a titration study – Continuous Positive Airway Pressure (CPAP) is very effective for any patient with Obstructive Sleep Apnea (OSA). It reliably lowers the apnea-hypopnea index (AHI) to below 5, ie the patient has no sleep apnea at all – as long as he is actively using the CPAP machine.

But patients don’t live in a controlled environment. When they go home, many of them either stop using their CPAP machine entirely or only use it for the first few hours of sleep before taking off their mask. This leads to residual sleep apnea during all the hours that you are not using your CPAP machine.

“There’s a difference between effectiveness and effectiveness,” says Ofer Jacobowitz MD, PhD, FAASM, FAAOA, co-director of Sleep, ENT and Allergy Associates in New York City and adjunct professor of ENT at the Zucker School of Medicine in Hofstra / Nordbrunnen.

“CPAP therapy is very effective and will almost always normalize the AHI,” says Jacobowitz. “At home, however, the effectiveness based on real results is not the same.”

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