Adjunctive Therapy to CPAP: Sedative Hypnotics, Heated Humidification, and Supplemental Oxygen

Continuous positive airway pressure (CPAP) therapy has many adjunctive measures for controlling obstructive sleep apnea (OSA). Sedatives and hypnotics may have a role in improving adherence to CPAP use, but long-term studies of the effectiveness of these medications are pending. Although evidence showing that heated humidification improves adherence is conflicting, it does have a role in improving nasal symptoms related to CPAP use. Oxygen clearly has a role in improving oxygen saturation nadir in patients with sleep-disordered breathing. It can also be helpful as a supplement to CPAP or bilevel devices for patients experiencing hypoventilation. Here authors propose a simple algorithm for evaluating patients with a clinical impression of OSA. In the end, the goal of health care providers is to improve the quality of life in patients with OSA and prevent the adverse consequences of untreated disease. For patients who agree to CPAP therapy, health care providers must work together with individual patients to tailor their care to improve adherence and, consequently, treatment of OSA.