Positive Airway Pressure (PAP) devices are a first line treatment option recommended by the American Academy of Sleep Medicine (AASM) for OSA. Through the medium of a mask over the nasal, oral, or oronasal interface (nose, mouth or both), PAP devices create a pneumatic splint (air support) to open the upper airway that is prone to collapse during apneic events. PAP may be delivered in continuous (CPAP), bilevel (BiPAP), autotitrating (APAP) or adaptive servo ventilation (ASV) modes. PAP is the standard treatment recommended for moderate to severe OSA, and is a primary option for mild OSA.
Although AASM Practice Parameters and Clinical Guidelines consider PAP the standard recommended clinical treatment modality for OSA (but not the only one), it requires proper introduction and education on the part of the Durable Medical Equipment (DME) provider, and an open mindset and willingness on the part of the patient. This is an extremely important dialogue since PAP compliance statistics are generally poor, hovering at or just above 50%; mostly because of pre-therapy biases, poor experiences during the introduction of PAP and inadequate attempts to accommodate.
Be sure to investigate a reputable DME source for introduction to PAP should your physician prescribe it. It is a well-established fact in sleep medicine that PAP compliance can rise significantly with a proper introduction to a suitable interface that fits well. Still, however, the dialogue remains two-sided. If the patient's attitude has been skewed by a reflexive bias against "sleeping with a mask", then PAP compliance will be an up-hill challenge from the start. Consider instead the entire vicious cycle of health that you have learned about, and how that snowball effect can work in the other direction to form a cascade of positive effects that feed off each other and assist other domains of your life. Based on the track record of PAP along with other forms of therapy for moderate to severe cases of OSA, PAP therapy should be a serious consideration. Full accommodation may take about a week after you receive the device. Remember, 76% of AASM survey respondents reported the quality of their sleep to be good to very good post-treatment versus only 7% before (n=506). The same survey also disclosed that 41% of respondents were finally diagnosed with severe OSA and 43% were moderate even though the initial physician's assessment guessed that 62% were mild, 30% moderate and only 8% severe. Get screened!