Continuous positive airway pressure therapy for obstructive sleep apnea has come a long way since the first devices and masks of the 1980s. The decibel levels have quieted to a whisper, the size to as small as the palm of a hand, and the interfaces have become available in an array of styles.
And I predict that the next generation of CPAP will become even easier to fit into patients’ lifestyles, potentially guiding patients toward better compliance. Sleep medicine professionals have great insight as to where the future will take us, as evidenced by a panel discussion that I hosted during a recent “Sleep Review Conversations” podcast episode (“The Future of Obstructive Sleep Apnea Therapy,” available at www.sleepreviewmag.com/resource-center/podcasts). According to the three distinguished panelists, there are several innovations that would be especially desirable—so manufacturers, take note!
Lighter humidifiers. The advent of CPAP humidification has been a comfort boon to patients, but it does introduce several inconveniences, namely additional bulk and cleaning requirements. David Westerman, MD, medical director of Northside Hospital Sleep Center, noted that smaller humidifiers or the incorporation of a technology that doesn’t require daily patient-initiated water changes would help many patients.
Easier cleaning. All panelists mentioned CPAP cleaning hurdles, and several touched on possible solutions. “Another thing that will enhance compliance is the ease of the CPAP unit, specifically the humidifier, to easily come apart so…the person can clean, sterilize, and maintain the device accordingly,” said Russell E. Rozensky, RRT-SDS, RPSGT, CPFT, MS, program director for the polysomnography technology program at Stony Brook University, and Sleep Review editorial advisory board member. On his wish list is infrared or UV light technology that could sterilize the device so even in case of accidental water contamination, the patient would not risk infection. Shari Angel Newman, RST, RPSGT, manager of Spartanburg Regional Medical Center and Sleep Review editorial advisory board member, adds a wish for an antimicrobial process built into CPAP devices to keep patients healthy.
Custom-molded seals. I asked the panelists about custom CPAP interfaces that would be built to a specific patient’s face. Rozensky replied that custom-molded seals would ensure better compliance, adding that fewer leak problems around the eyes, nose, and other areas would convince patients to use the therapy more often. Westerman added: “As perhaps [customization] gets more commercialized and the price comes down, I think it will be an important part of our armamentarium because, after all, compliance is crucial. The interface is the point of contact.”
Travel-friendly features. Smaller devices, perhaps with convenient battery backup or that would work on one charge for days, would help since travel is a significant part of modern-day life, Westerman said, adding that the patient’s first impression of a small CPAP would likely be better as well.
Ultimately, any technological innovations in therapies will work best in tandem with diagnostic innovations. Though physicians might not yet be asking the right screening questions, Rozensky predicted that eventually proper sleep disorder screening will be routine. He predicted that within a decade at most, routine sleep screenings will be looked at as a preventative therapy—a worthy objective that we should all add to our wish lists.
Sree Roy is editor of Sleep Review.