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Consensus Statement |

Indications for Positive Airway Pressure Treatment of Adult Obstructive Sleep Apnea Patients*: A Consensus Statement

Daniel I. Loube, MD, FCCP; Peter C. Gay, MD, FCCP; Kingman P. Strohl, MD, FCCP; Allan I. Pack, MD, PhD; David P. White, MD, FCCP; Nancy A. Collop, MD, FCCP
Author and Funding Information

*From Walter Reed Army Medical Center (Dr. Loube), Washington, DC; Mayo Clinic (Dr. Gay), Rochester, MN; Case Western Reserve University (Dr. Strohl), Cleveland, OH; University of Pennsylvania (Dr. Pack), Philadelphia, PA; Harvard University (Dr. White), Boston, MA; and Medical University of South Carolina (Dr. Collop), Charleston, SC.



Chest. 1999;115(3):863-866. doi:10.1378/chest.115.3.863
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We developed a short-length document that clearly delineates a prudent approach to and criteria for reimbursement of positive airway pressure (PAP) costs for the treatment of obstructive sleep apnea (OSA). Treatment modalities for OSA with PAP include continuous positive airway pressure, bilevel or variable PAP, and autotitrating PAP. This guidance on the appropriate criteria for PAP use in OSA is based on widely acknowledged peer-reviewed studies and widely accepted clinical practice. These criteria reflect current opinion on the appropriate clinical management of OSA in lieu of data pending from the Sleep Heart Health Study and upcoming outcome studies. This document is not intended to provide a complete review and analysis of the OSA clinical literature. The key to the success of this document is to foster consensus within and outside the clinical sleep community by providing a common sense and easily understood approach to the treatment of OSA with PAP.

Abbreviations: CPAP = continuous positive airway pressure; EMG = electromyogram; EOG = electro-oculogram; NPSG = nocturnal polysomnography; OSA = obstructive sleep apnea; PAP = positive airway pressure; RDI = respiratory disturbance index; RERA = respiratory effort-related arousal


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