ABSTRACT
The capability of continuous positive airway pressure (CPAP), delivered through a noninvasive interface to maintain upper airway patency during sleep in patients with obstructive sleep apnea/hypopnea (OSA/H) has been well established (1-11). Se´rie`s et al. have confirmed the hypothesis of Sullivan and coworkers that the primary mechanism of action is through pneumatic splinting of the airway (1,12). As a consequence of stabilizing the upper airway during sleep in OSA/H patients, CPAP therapy is associated with improved daytime alertness and improvement in at least some parameters of cognitive function (13-18). While the effectiveness of nasal CPAP in maintaining upper airway patency during sleep in OSA/H patients is undisputed, suboptimal patient compliance with this therapy is equally undisputed (19-25). Since these two facts became evident, the thrust of technology has been directed towards modifying existing or developing new techniques and modalities that would be equally effective but more readily accepted and consistently utilized by patients. These efforts have resulted in an increasing number of interface options from which patients may choose as well as a modest broadening of available positive pressure modalities.
