Continuous positive airway pressure therapy in obstuctive sleep apnea: benefits and alternatives

Abstract

Obstructive sleep apnea (OSA) is a highly prevalent condition affecting persons of all age with an increasing public health burden. It is implicated in cardiovascular disease, metabolic syndrome, neurocognitive impairment, reductions in quality of life, and increased motor vehicle accidents. The goals of OSA treatment are to improve sleep and daytime symptoms, and minimize cardiovascular risks.Areas covered: Continuous positive airway pressure (CPAP) is considered the gold standard therapy that delivers pressurized air into the upper airway to relieve obstruction during sleep. Although CPAP is an effective modality of treatment for OSA, adherence to therapy is highly variable. This article highlights the benefits of CPAP therapy, along with alternative treatment options including oral appliance, implantable and wearable devices, and surgery. Expert commentary: CPAP therapy is the gold standard treatment option and should continue to be offered to those who suffer from OSA. Alternative options are available for those who are unable to adhere to CPAP or choose an alternative treatment modality. The most interesting advances have been incorporating orthodontic procedures in conjunction with myofunctional therapy in prepubertal children, raising the possibility of OSA prevention by initiating treatment early in life.

Obstructive sleep apnea and obesity: implications for public health

“…If the condition does not improve, then surgical procedures are recommended to overcome this problem. 76 Surgical weight loss procedures for obese people are highly recommended, even by non-surgical teams and societies. 77 Bariatric surgical procedures are safe, even in the elderly population, so this should not be a deterrent to undergo the operations.…”

Treatment with CPAP in Elderly Patients with Obstructive Sleep Apnoea

“…It is well recognised that the treatment of choice for the most serious or symptomatic forms of OSA is continuous positive airway pressure (CPAP). This treatment has proved successful in improving not only patients' sleep-related symptoms (particularly daytime sleepiness) and quality of life, but also CPAP has a significant impact on the metabolic, cardiovascular and neurocognitive consequences of OSA [3]. However, most of the key studies that have established the criteria for the indication of CPAP were performed on middle-aged males [4,5], and their results have subsequently been extrapolated to other age groups and to women-even though it has been established that the clinical manifestations, and consequences of OSA vary with age and sex.…”

Qualidade do sono em pacientes com apneia obstrutiva após cinco anos de uso de CPAP

“…Dados indicam que pacientes com menores dimensões cefalométricas e com fraqueza de tecidos moles orofagíngeo tendem a ter uma menor adesão ao tratamento, e estes dois fatores estão fortemente associados com o sobrepeso e a obesidade, característica altamente prevalente na população com SAHOS 6,7 . Nestes casos, é essencial o trabalho do profissional fisioterapeuta para treinamento, adaptação e aumentar a persistência do pacientes, para que o tratamento seja continuado e obtenha sucesso 7,8 . Já é claro na literatura que a SAHOS é uma condição altamente prevalente que afeta pessoas de todas as idades, levando a sérios problemas de saúde pública.…”

“…Já é claro na literatura que a SAHOS é uma condição altamente prevalente que afeta pessoas de todas as idades, levando a sérios problemas de saúde pública. Como altera qualidade de sono e influencia no bem estar do paciente, já está associada com doenças cardiovasculares, síndrome metabólica, comprometimento neurocognitivo e aumento dos acidentes automobilísticos 8 . Sabendo que o CPAP é o tratamento de escolha, justifica-se este estudo para verificar padrões de sonolência diária, qualidade do sono, riscos e padrões antropométricos em pacientes tratados e acompanhados por 5 anos.…”