ABSTRACT
Continuous positive airway pressure (CPAP), usually nasally applied, is the established treatment for moderate-to-severe obstructive sleep apnea (OSA) (1). Nasal CPAP therapy for sleep apnea was first described in 1981 (2). Although there was initial skepticism of its efficacy and concern regarding its potential adverse effects on breathing (3,4), there was also early recognition of the importance of having a treatment that could essentially prevent disordered breathing during sleep in OSA patients. This is in contrast to the efficacy of other alternatives available, including partial or variable response to surgery (5). By 1985, more than 100 patients were using this therapy on a regular basis (6). Over the past 20 years, the evidence base supporting the use of CPAP has improved both in quantity and quality, driven at least in part by the demands of government funding authorities and health maintenance organizations and the availability of industry sponsorship with the increasing commercial success of companies selling CPAP equipment (7).
