Vingt ans de traitement par la pression positive continue automatique

Continuous positive airway pressure remains the most effective treatment of the obstructive sleep apnea syndrome. The benefits associated with its utilization and with the conditions allowing for a better treatment observance have been well explored in systematic evaluations. The development of automatic positive pressure devices initially led to the concept that this treatment mode could become the reference treatment. However, 20 years after its initial description, the benefits of this therapeutic strategy are not demonstrated by the results of meta-analyses conducted now on. This kind of treatment could have specific indications such as the need for high positive pressure levels or patients having difficulties to remain compliant to fixed pressure treatment. The use of these devices to conduct titrating procedures should take into account for the variability in the recommended pressure levels between the different machines.