Revista de trastornos del sueño: tratamiento y cuidados

A New FDA Cleared Expiratory Resistance Device for Treatment of Snoring and Low Levels of Obstructive Sleep Apnea

Hakim TS and Camporesi EM

Expiratory Positive Airway Pressure (EPAP) devices have been successfully used to treat obstructive sleep apnea and snoring. A new EPAP device called “Optipillows EPAP Mask” has recently been cleared by the FDA for treatment of snoring. The goal of this study is to describe the new EPAP mask and characterize its resistance properties. The EPAP mask consists of a nasal pillow type mask with head straps and with a proprietary micro valve on the front of it. The EPAP mask allows inhalation with minimal resistance, but with more resistance during exhalation causing the pressure to be elevated. The expiratory resistance can be adjusted according to patient’s comfort. The pressure generated by the EPAP mask was evaluated using a breathing system that simulated normal breathing pattern at rest. With the expiratory resistance fully open (minimal resistance) peak expiratory pressure generated by the mask was 1.3 to 3.2 cm H2O depending on tidal volume. A larger tidal volume generated more pressure during expiration. Peak expiratory pressure increased as the expiratory resistance was increased. The expiratory resistance range of the EPAP mask is comparable to previous EPAP devices. EPAP devices have limitations. A patient must take as long as necessary to learn to sleep comfortably with low resistance on the EPAP mask, before rushing to increase the resistance. For treatment of snoring a low level of expiratory resistance may be sufficient. The EPAP mask may also be useful for treatment of low levels of obstructive sleep apnea.