Clinical efficacy of a nasal expiratory positive airway pressure (EPAP) device for the treatment of obstructive sleep apnea

Introduction: PROVENT® Therapy (Ventus Medical Inc.) is a novel and effective nasal EPAP treatment for patients with OSA. It is well tolerated, easy to use and less cumbersome than traditional therapies. Methods: Eligible patients in this community based sample had OSA and were treatment naive, or they had tried and failed CPAP. A total of 123 patients were offered nasal EPAP. Polysomnography was recommended if patients intended to use nasal EPAP as a primary treatment, OSA severity was moderate to severe, or OSA severity was mild and accompanied by medical co-morbidities. Results: Of the 123 patients offered nasal EPAP 64% were CPAP failures, 32% were treatment naive and 4% had tried therapies other than CPAP. There were no differences in age (51 yrs ± 10), gender (72% men) or BMI (32 ± 6) between the entire sample and those patients with PSG data. Follow-up is pending for 53 patients. In the analysis of the remaining 70 patients 41 (59%) accepted therapy after an initial trial. Eleven are continuing with nasal EPAP therapy based on physician evaluation and subjective symptom relief. Polysomnographic data were available for 30 patients. Treatment success was defined as a reduction in AHI ≥ 50% or an AHI < 10. Twenty four patients (80%) were effectively treated. The median AHI was reduced from 17.1 to 4.9 (p < .0001). There was a trend toward lower mean Epworth scores [7.2 to 5.5 (p=0.07)]. Conclusion: Nasal EPAP is an effective and well tolerated initial treatment option for patients with mild to moderate OSA or for patients who cannot tolerate CPAP.