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Positive Airway Pressure (PAP) Therapy Compliance: Increasing Use through Technological Advances
Posted on: 2008-12-03 | by SleepCenterInfo.com
Changes in PAP therapy over the years have made this type of therapy much easier to tolerate.
Positive Airway Pressure (PAP) Therapy Compliance:
Increasing Use through Technological Advances
Obstructive sleep apnea (OSA) is the most common sleep disorder, affecting one in five Americans. OSA is a repeated reduction or stoppage in breathing during sleep, most often due to a narrowing or even a collapse in the upper airway (throat area). Patients diagnosed with OSA generally have three treatment options: 1) positive airway pressure (PAP) therapy, 2) surgical procedures (having marginal success), and 3) an oral appliance (useful only in patients with mild OSA). The most commonly used and effective treatment for OSA is PAP therapy.
PAP therapy involves wearing a small pressurized mask that maintains an elevated air pressure throughout the nasal passageway, down to the upper airway. This elevated air pressure holds the upper airway open, effectively eliminating OSA in many cases. One of the main drawbacks to PAP therapy for some patients is the prospect of wearing the PAP equipment during sleep. For many patients, their ability to tolerate PAP therapy interferes with treatment of their OSA, which can ultimately have devastating health consequences. Most sleep practitioners have a goal of getting patients to wear their PAP equipment each night, throughout the night, but are successful in only half of their patients. At the Sleep Centers of Middle Tennessee we have made huge advances in PAP compliance for many of our patients, mainly due to technological advances and an innovative follow up program, achieving nearly 90% compliance to PAP therapy.
Changes in PAP therapy over the years have made this type of therapy much easier to tolerate. Mask improvements such as the development of nasal pillows - a small, fitted mask that rests underneath the nose, rather than over the nose - have made PAP easier to tolerate. This type of mask is particularly useful for those patients who suffer from claustrophobia or anxiety surrounding wearing the PAP mask. Advancements also have been made in the standard masks (which fit over the nose) and the full face masks as well. Hypoallergenic masks are helpful to those who have latex allergies or breakouts from wearing the PAP mask.
New and improved pressure delivery systems also have been developed, in the realm of PAP therapy, helping to improve patients' ability to tolerate PAP. Flex technology has been patented by one PAP company - this type of pressure delivery system helps patients to tolerate PAP via utilization of a drop in pressure just before the exhalation process starts. As such, patients find it easier to breathe out against the PAP pressure, particularly those patients who are on higher PAP pressures. For some patients, bilevel PAP (commonly known as BiPAP) is also a good alternative. This type of pressure delivery has two pressure settings - an inhaling pressure, and an exhaling pressure. The bilevel PAP unit detects the start of the exhalation process and drops from the higher (inhaling) pressure setting to the lower (exhaling) pressure setting.
PAP therapy improvements have also been made in the filtration systems, designed to filter out most air impurities and minimize sinus and allergy symptoms. Also, most PAP units now come with an option of heated humidity. Patients using a PAP unit with a heated humidifier receive air pressure which has passed over warm water. This heated, humidified air not only helps patients to avoid the cold, dry feeling in the nose and mouth experienced by many PAP patients in the past, but also may help to control sinus and allergy symptoms in certain patient populations. Additionally, PAP units have been designed to be much quieter, thus minimizing disruption to patients' and their bedpartners' sleep. Finally, most of the PAP units used by the Sleep Centers of Middle Tennessee come equipped with compliance and PAP therapy monitoring technology. This compliance and PAP therapy monitoring technology comes in the form of a memory card housed in the rear of the PAP unit. Patients bring this card to their follow up visits, at which time data is downloaded from the card related to: nightly use, residual respiratory events, leaks, and multiple other factors. Variations of this technology are also found in the compliance monitoring that is done via telephone line/modem and wireless technology. The Sleep Centers of Middle Tennessee was one of the first organizations in the country to test and utilize this technology, which is useful in that it helps our practitioners to troubleshoot and correct problems tolerating PAP.
The Sleep Centers of Middle Tennessee is committed to providing comprehensive follow up for our PAP therapy patients. Research indicates that one of the most important predicting factors in a patient's long term success with PAP therapy is thorough follow up in the early stages of PAP use. As such, we have protocols by which we schedule our PAP therapy patients for follow up appointments at strategic times soon after starting PAP therapy. Close telephone follow up is also conducted in the beginning phases of PAP use. By adhering to this approach, the Sleep Centers of Middle Tennessee has consistently maintained a PAP compliance level much higher than the national average. For further information regarding OSA, PAP therapy, or other information contained in this article, please feel free to contact us at (615) 893-4896 or by e-mail on the Contact Us page.
