ABSTRACT
The most effective treatment to avoid the sleep disturbances characterizing patients with obstructive sleep apnea (OSA) is the application of a constant positive pressure at the airway opening (CPAP) by means of a nasal mask. Although OSA is the most prevalent sleep related breathing disorder (SRBD), a non-negligible proportion of SRBD patients suffer from ventilation disturbances requiring nocturnal ventilatory support different from CPAP. On the one hand, in some patients, OSA is accompanied by alterations that compromise adequate ventilation. For instance, OSA patients with concurrent morbid obesity or chronic obstructive pulmonary disease (COPD) may require not only a CPAP to splint the collapsible upper airway but also a mechanical ventilatory support to overcome the increased mechanical load to breathing associated with these concurrent disorders. On the other hand, patients with non-OSA sleep breathing disturbances such as Cheyne-Stokes breathing may also require noninvasive ventilatory support to compensate for an insufficient inspiratory drive during sleep.
