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Nasal Positive Airway Pressure Improves Obstructive Sleep Apnea LONDON, ENGLAND -- June 18, 1999 -- Obstructive sleep apnea, most common in men, is a disorder in which airflow to the lungs from the nose and mouth is restricted during sleep. The disorder interrupts sleep and leads to excessive daytime sleepiness. Nasal continuous positive airway pressure (NCPAP), which keeps the airway open during sleep, is widely used as a treatment for obstructive sleep apnea. Until now there have been no successful randomised controlled trials of NCPAP therapy against a well-matched control. This is partly because of difficulties involved in finding a suitable group of people to act as controls in testing a therapy that involves wearing a mask over the nose at night. In a report in this week's issue of The Lancet, Dr Crispin Jenkinson and colleagues, from Oxford, England, circumvented this problem by giving men with severe sleep apnea either NCPAP treatment at a therapeutic pressure, or the same NCPAP treatment set at a subtherapeutic pressure. One hundred and seven men took part in the study: 54 received therapeutic NCPAP and 53 received subtherapeutic NCPAP. Patients were assessed by means of subjective and objective measurements of daytime sleepiness and by questionnaire. The group that received therapeutic NCPAP showed significant improvement in self-reported health status after treatment compared with the control group (questionnaire score for general health perception: 70.5 for therapeutic NCPAP versus 62.2 for subtherapeutic NCPAP) and less daytime sleepiness after treatment than the control group (maintenance-of-wakefulness test: 32.9 min for therapeutic NCPAP versus 23.5 min for subtherapeutic NCPAP). "The main symptom of obstructive sleep apnea [sleepiness] was significantly improved by therapeutic NCPAP," the researchers write, adding that more work is needed to define the lower end of the range of severity of sleep apnea for which NCPAP would be effective. Related Link: The Lancet E-mail this page to a friend or colleague! To print, use this version