[Non-surgical treatment of obstructive sleep apnea]

We studied the clinical usefulness of nasal continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea syndrome (OSAS). The subject were 56 men with OSAS. Their mean age, apnea index, and SaO2 were 51 +/- 8 years, 48 +/- 18, and SaO2 were 51 +/- 8 years, 48 +/- 18, and 81 +/- 7%, respectively. After titration of CPAP, they underwent nasal CPAP treatment at home every night. Symptoms, blood pressure, pulmonary function, compliance with the prescription and complications of treatment were evaluated every one or two months in an outpatient clinic. Blood pressure decreased significantly from 135 +/- 15 mmHg (systolic) and 88 +/- 14 mmHg (diastolic) to 126 +/- mmHg (systolic) and 78 +/- 6 mmHg (diastolic) in 51 cases after two weeks of treatment. No significant change in pulmonary function except for blood gases was observed after longterm treatment. Excessive daytime sleepiness disappeared and sleep quality improved after treatment in most cases. Thirty-six of 43 patients continued to use nasal CPAP for 34 +/- 16 months and 33% complied with the prescription. Although nasal mask discomfort and dryness of the nose and mouth occurred in several cases, there were no serious complications. These findings suggest that nasal CPAP is useful for treatment of patients with OSAS. However, the problem remains that the cost of nasal CPAP is not reimbursed by the public health insurance system in Japan.