Use of Auto-titrating Positive Airway Pressure Devices for Sleepdisordered Breathing: The Good, the Bad and the Ugly

Abstract

Auto-titrating positive airway pressure (APAP) devices are an effective treatment alternative for certain patients with obstructive sleep apnea (OSA). In patients with positional sleep apnea and sleep stage dependent OSA, APAP devices may be more preferable than continuous positive airway pressure (CPAP). The myriad of APAP machines currently available employ increasingly sophisticated mathematical algorithms to identify and ameliorate respiratory disturbances. The cardiovascular benefits accrued from consistent CPAP usage still remain to be proven with APAP use. Although a reasonable alternative to CPAP, APAP titration or treatment should not be used in patients in whom OSA coexists with risk factors for central sleep apnea and hypoventilation syndromes.