Why are only about 50% of obstructive sleep apnea patients CPAP adherent? New data spurs some sleep specialists to look differently at positive airway pressure flow profiles—and suggest pressure relief might be best placed where we least expect it. 

By Chaunie Brusie, RN, BSN

For the past two decades, CPAP devices have been designed to maintain inspiratory pressure—the pressure level when a patient inhales—for the treatment of obstructive sleep apnea. 

Technical improvements, such as increasingly faster-to-adjust turbines within CPAPs, have made maintaining inspiratory pressure even more seamless. Patients who express trouble with their pressure settings have their CPAP expiratory pressure dropped—a lessening of the pressure level during exhalation—via an expiratory pressure relief feature available on many of today’s devices or a ramp feature, which drops both inspiratory and expiratory pressure together for about 30 minutes before gradually increasing both to the prescribed pressure. 

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