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Many have speculated on why studies on CPAP have not confirmed the expected benefits; some cite lack of treatment compliance, and others suggest that the apnea hypopnea index is an imperfect measure of apnea (although CPAP treatment appears to benefit nearly all methods that have been proposed to measure OSA). Nonetheless, considering our current knowledge, many of the supposed benefits can no longer be presumed. However, it’s important not to overlook the benefits that have been associated with CPAP use, particularly daytime alertness, and possibly improved blood pressure. Treatment of these issues alone can significantly improve quality of life for patients and should not be diminished or overlooked. Therefore, CPAP has great value to public health and safely and should continue to be strongly promoted as a treatment for apnea.
The collection of articles in this issue of Sleep Medicine Clinics takes a comprehensive look at many aspects of sleep apnea treatment. Topics range from reviews of the outcome data of CPAP treatment in diverse populations, to practical analysis of different mask interfaces, and how to treat hypoventilation with positive airway pressure. Like the field, authors of various articles discuss many of the same research studies, but often with different and sometimes opposing views, particularly when discussing the benefits or lack thereof of CPAP on cardiovascular risks. This makes for interesting reading.