Continuous positive airway pressure

Moderate to severe obstructive sleep apnea CPAP is the most effective treatment for moderate to severe obstructive sleep apnea, in which the mild pressure from the CPAP prevents the airway from collapsing or becoming blocked. CPAP has been shown to be 100% effective at eliminating obstructive sleep apneas in the majority of people who use the therapy according to the recommendations of their physician. Use of CPAP for people with sleep apnea reduces the overall risk of death from cardiovascular causes. Upper airway resistance syndrome Upper airway resistance syndrome (UARS) is another form of sleep-disordered breathing with symptoms that are similar to obstructive sleep apnea, but is instead marked by increased airway resistance and frequent sleep disruptions without the complete airway collapse or significant oxygen desaturation characteristic of OSA. CPAP can be used to treat UARS as the condition progresses, in order to prevent it from developing into obstructive sleep apnea. Pre-term infants CPAP also may be used to treat pre-term infants whose lungs are not yet fully developed. For example, physicians may use CPAP in infants with respiratory distress syndrome. It is associated with a decrease in the incidence of bronchopulmonary dysplasia. In some preterm infants whose lungs have not fully developed, CPAP improves survival and decreases the need for steroid treatment for their lungs. In resource-limited settings where CPAP improves respiratory rate and survival in children with primary pulmonary disease, researchers have found that nurses can initiate and manage care with once- or twice-daily physician rounds. Asthma CPAP can be used for the treatment of obstructive pulmonary diseases including asthma. COVID-19 In March 2020, the USFDA suggested that CPAP devices may be used to support patients affected by COVID-19; however, they recommended additional filtration since non-invasive ventilation may increase the risk of infectious transmission. Other uses CPAP also has been suggested for treating acute hypoxaemic respiratory failure in children. However, due to a limited number of clinical studies, the effectiveness and safety of this approach to providing respiratory support is not clear. ==Contraindications==

CPAP cannot be used in the following situations or conditions: • A person is not breathing on their own • A person is uncooperative or anxious • A person cannot protect their own airway (i.e., has altered consciousness for reasons other than sleep, such as extreme illness, intoxication, coma, etc.) • A person is not stable due to respiratory arrest • A person has experienced facial trauma or facial burns • A person who has had previous facial, esophageal, or gastric surgery may find this a difficult or unsuitable treatment option, or may need to fully heal from surgery before using this treatment == Adverse effects==

Some people experience difficulty adjusting to CPAP therapy and report general discomfort, nasal congestion, abdominal bloating (including increased flatulence), sensations of claustrophobia, mask leak problems, and convenience-related complaints. == Mechanism ==

CPAP therapy uses machines specifically designed to deliver a flow of air at a constant pressure. CPAP machines possess a motor that pressurizes room temperature air and delivers it through a hose connected to a mask or tube worn by the patient. This constant stream of air opens and keeps the upper airway unobstructed during inhalation and exhalation. and connectivity to allow data from during sleep to be viewed with a smartphone app. The therapy is an alternative to positive end-expiratory pressure (PEEP). Both modalities stent open the alveoli in the lungs and thus recruit more of the lung surface area for ventilation. However, while PEEP refers to devices that impose positive pressure only at the end of the exhalation, CPAP devices apply continuous positive airway pressure throughout the breathing cycle. Thus, the ventilator does not cycle during CPAP, no additional pressure greater than the level of CPAP is provided, and patients must initiate their breaths. Method of delivery of CPAP Nasal CPAP Nasal prongs or a nasal mask is the most common modality of treatment. Frequently, nasal CPAP is used for infants, although this use is controversial. Studies have shown nasal CPAP reduces ventilator time, but an increased occurrence of pneumothorax also was prevalent. Nasopharyngeal CPAP Nasopharyngeal CPAP is administered by a tube that is placed through the person's nose and ends in the nasopharynx. There are also devices that combine nasal pressure with mandibular advancement devices (MAD). The use of specialized surgical tape appropriate for placement over the mouth with lips closed, or a flexible cloth chin strap to hold the jaws together, are other options to prevent air leaks while sleeping. == Compliance ==

A large portion of people do not adhere to the recommended method of CPAP therapy, with more than 50% of people discontinuing use in the first year. A significant change in behavior is required in order to commit to long-term use of CPAP therapy and this can be difficult for many people, since CPAP equipment should be used consistently for all sleep (including naps and overnight trips away from home) and needs to be regularly maintained and replaced over time. In addition, people with moderate to severe obstructive sleep apnea have a higher risk of concomitant symptoms such as anxiety and depression, which can make it more difficult to change their sleep habits and to use CPAP on a regular basis. Educational and supportive approaches have been shown to help motivate people who need CPAP therapy to use their devices more often. == History ==

CPAP was developed by Dr. George Gregory and colleagues in the neonatal intensive care unit at the University of California, San Francisco. Dr. Colin Sullivan, an Australian physician and professor, invented a machine in 1980 applying CPAP for use on adult patients with sleep apnea at Royal Prince Alfred Hospital in Sydney. Gerald McGinnis, founder of Respironics, began selling one of the first commercially available CPAP machines for adults with sleep apnea in 1985. ==See also ==