Intelligent CPAP

CPAP, or more properly Nasal Continuous Positive Airway Pressure (nCPAP) was first used to treat obstructive sleep apnoea (OSA) patients by Professor Colin Sullivan of Sydney, Australia in the late 70's. Here, the author looks at the development and utility of 'automatic' or 'intelligent' self pressure setting CPAP systems rather than to describe the design of the pump system and the feedback required to produce an acceptable pressure during inhalation without an accompanying expiratory pressure rise. These machines have the aim of adjusting the CPAP pressure to the needs of the patient at any particular time, to have a minimal wake pressure and a lower mean pressure, and also to be able to document the night-time respiratory events. This latter mode lends itself to use in 'titration' in the sleep laboratory where what is required is a self adjusting device which adapts the pressure to that needed for the patient without necessarily having an overnight technician present.