I am a new patient and this site is great.  Forgive me if this is in a FAQ, but my research on the Internet seems to indicate that scientific and clinical evidence definitively supporting the fact that CPAP is effective does not seem to exist yet.  Is that true ?  I read that it is the most prescribed treatment for OSA and that compliance is key to success (as well as diet and exercise) however there does not seem to be any clinical studies that validate the claim that CPAP actually works.

I feel like I have just come out of a five year coma and have never felt better but how I "feel" is not very scientific.  Is there a study that you can point to that is the president to the effectiveness of CPAP.  Also how about long term treatment.  Is their a diminishing return.  In other words, does it remain effective all the time ?

Thanks gang.

I guess I am too easily satisfied. I could give a rat's rear whether I'm doing so much better since starting CPAP because of the CPAP or because of the "placebo effect". On the other hand, many other things do arouse my curiosity and I've been accused of asking "too many unncessary questions" by a doctor so who I am to question your desire to know?


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Do some searches on Medline or Pub Med, two excellent sources for clinical research papers.  The evidence to support CPAP is there.  If you do not find what you're looking for, PM me and I'll help you dig up some links.

Nothing I have read so far, indicates "diminishing returns"...  Obstructive sleep apnea (OSA) tends to worsen as we age, and sometimes pressure requirements go up or down as we age as well.  It is important to have routine followups, whether months or years apart, so that changes in severity or changes in pressure, can be recognized and CPAP therapy adjusted.  If someone does not have followups or does not see their doctor when therapy isn't working well any longer, it could very well be interpreted as "diminishing returns" when in fact it is simply a moving target

Note there is no correlation between severity (events per hour aka AHI), and pressure required to keep your airway open.  Some folk have very severe SA and only need low pressure, while others have mild SA and require very high pressure.  The pressure is whatever YOU need to keep YOUR airway open.

Blessings,
--pseudonym

I would think that the Before and After results from your sleep studies would show conclusively that CPAP (or XPAP) is effective.  If Before shows a lot of apneas and hypopneas and After shows very few or none, voila - proof!

Frances wrote:

I would think that the Before and After results from your sleep studies would show conclusively that CPAP (or XPAP) is effective.  If Before shows a lot of apneas and hypopneas and After shows very few or none, voila - proof!

I am interested in clinical studies that demonstrates that it works.  I know that I feel better and my before sleep study shows an average of 76 AHI's a night and my CPAP now indicates about 5.5 clearly a vast improvement.  I did see my post sleep study when they did my titration and it indicated at a pressure level my AHI was zero but is my oxygen level improved.  Is my blood pressure lower ?

Since this is the accepted Rx for sleep apnea I am surprised that there is not a definitive clinical study that states clearly the benefits of this treatment.

jbandes wrote:

Since this is the accepted Rx for sleep apnea I am surprised that there is not a definitive clinical study that states clearly the benefits of this treatment.

So you did not see my post?

Blessings,
--pseudonym

pseudonym wrote:

jbandes wrote:

Since this is the accepted Rx for sleep apnea I am surprised that there is not a definitive clinical study that states clearly the benefits of this treatment.

So you did not see my post?

Blessings,
--pseudonym

Opps missed that.

Medline shows requests for participants for long term CPAP studies now being conducted.  I am looking for a clinical study that has already been conducted not one that is looking for participants.  If you have a link in any of the medical journals or one that is published that is what I am looking for.  I do find the medline interesting but again looking for a published study.

jbandes wrote:

pseudonym wrote:

jbandes wrote:

Since this is the accepted Rx for sleep apnea I am surprised that there is not a definitive clinical study that states clearly the benefits of this treatment.

So you did not see my post?

Blessings,
--pseudonym

Opps missed that.

Medline shows requests for participants for long term CPAP studies now being conducted.  I am looking for a clinical study that has already been conducted not one that is looking for participants.  If you have a link in any of the medical journals or one that is published that is what I am looking for.  I do find the medline interesting but again looking for a published study.

Its things like this that are a turn off (This is however old 1999) so I will keep looking.

More Data on CPAP for Obstructive Sleep Apnea

A recent systematic review concluded that the effectiveness of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea has been "poorly evaluated" . . .

— AS Brett

Published in Journal Watch Psychiatry May 1, 1999

Quote:

In 1997 a much debated paper was published in the British Medical Journal that reviewed the research evidence for the health consequences of OSA and the effectiveness of continuous positive airway pressure (CPAP) therapy (3). The authors concluded that the health effects of OSA were exaggerated and that the effectiveness of CPAP in improving health outcomes had been poorly evaluated. The state of the literature on oral appliance therapy was even more deficient with few controlled trials. Many clinicians and scientists did not agree with the overall conclusions of the article (4) but most agreed that further research was needed (5). The state of the CPAP literature has improved considerably since 1997 but the debate continues (6, 7).

Now dont misunderstand, I love my CPAP and feel amazingly better but I am looking for studies that prove that it works clinically.  I would like to add too that the new Mirage Swift II LT mask is amazing.  So much better than the original.  

When I find a study that supports CPAP I will post the link for everyone as I am sure someone has published one

Thanks everyone.

PS:  Finally found one from 2001

http://ajrccm.atsjournals.org/cgi/content/abstract/164/4/608

Seeking More.