The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

CPAP, BIPAP'^{TM}', VPAP: Making Sense of Available Devices and Options

Allan B. Saposnick, MS, RRT Monday, November 4, 1996

The National Commission on Sleep Disorders Research estimates that 95% of patients with sleep disorders remain undiagnosed and that in 1990, sleep disorders cost the U.S. $15.9 billion. In addition, the cost of untreated sleep disorders is astronomical in terms of reduced quality of life, lower productivity in school and the workplace, increased morbidity and mortality and, the loss of life due to accidents caused by excessive sleepiness. Approximately 20-30 million American adults suffer from obstructive sleep apnea. A recent survey concluded that as many as 9% of all women and 24% of all men suffer from sleep-disordered breathing, including approximately 6 million who suffer from severe obstructive sleep apnea. To date, only about 400,000 cases of obstructive sleep apnea have been diagnosed.

Sleep apnea is the most common type of sleep disorder, and the easiest to diagnose and treat. Products for the treatment of obstructive sleep apnea have been available since 1984. As the market for these products grows, demand increases for newer technologies to provide improved patient outcomes, while simultaneously reducing costs.

Eight companies currently have a total of at least twenty different models of Continuous Positive Airway Pressure (CPAP) devices. These units progress from the very basic systems to units which sense various changes in the patient's breathing pattern and automatically adjusts pressure to compensate and maintain a patent airway. Several units also have memory which retains information about usage, compliance, pressure changes which can be downloaded, printed and interpreted.

Units providing the capability of separate adjustment of inspiratory and expiratory pressure, BiLevel systems, are proliferating and becoming more sophisticated. They offer the basic capability of providing increased comfort and compliance for the CPAP user having difficulty all the way to units which provide full pressure assisted ventilation with a wide array of adjustments, alarms and feed back.

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