TY - JOUR
T1 - Bilevel positive airway pressure for obstructive sleep apnea
AU - Mansukhani, Meghna P.
AU - Kolla, Bhanu Prakash
AU - Olson, Eric J.
AU - Ramar, Kannan
AU - Morgenthaler, Timothy I.
N1 - Funding Information:
TI Morgenthaler conducted research funded by ResMed, Inc regarding treatment of Complex Sleep Apnea Syndrome. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
PY - 2014/5
Y1 - 2014/5
N2 - For most patients with obstructive sleep apnea syndrome (OSA), continuous positive airway pressure (CPAP) is an effective therapy. However, for a subset of individuals, CPAP is either not effective or is poorly tolerated. Bilevel positive airway pressure (BPAP) is potentially capable of treating OSA at a lower mean pressure than CPAP and can help augment ventilation via pressure support. This review summarizes the evidence for the use of BPAP in spontaneous mode in the initial treatment of patients with OSA and in those who are poorly compliant with CPAP therapy. It also examines evidence regarding use of BPAP in OSA with associated hypoventilation, such as in chronic obstructive pulmonary disease or severe obesity. Finally, current clinical guidelines that help determine which patients would be candidates for a BPAP device and how to manually titrate BPAP to determine the optimal settings to be prescribed are also discussed.
AB - For most patients with obstructive sleep apnea syndrome (OSA), continuous positive airway pressure (CPAP) is an effective therapy. However, for a subset of individuals, CPAP is either not effective or is poorly tolerated. Bilevel positive airway pressure (BPAP) is potentially capable of treating OSA at a lower mean pressure than CPAP and can help augment ventilation via pressure support. This review summarizes the evidence for the use of BPAP in spontaneous mode in the initial treatment of patients with OSA and in those who are poorly compliant with CPAP therapy. It also examines evidence regarding use of BPAP in OSA with associated hypoventilation, such as in chronic obstructive pulmonary disease or severe obesity. Finally, current clinical guidelines that help determine which patients would be candidates for a BPAP device and how to manually titrate BPAP to determine the optimal settings to be prescribed are also discussed.
KW - bilevel positive airway pressure
KW - hypercapnia
KW - hypoventilation
KW - obstructive sleep apnea
KW - titration
UR - http://www.scopus.com/inward/record.url?scp=84898464849&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84898464849&partnerID=8YFLogxK
U2 - 10.1586/17434440.2014.900435
DO - 10.1586/17434440.2014.900435
M3 - Review article
C2 - 24666419
AN - SCOPUS:84898464849
SN - 1743-4440
VL - 11
SP - 283
EP - 294
JO - Expert Review of Medical Devices
JF - Expert Review of Medical Devices
IS - 3
ER -