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Volume 10 No. 05
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Accepted Papers

Case Reports

Complex Sleep Apnea Associated with Use of Nasal Expiratory Positive Airway (nEPAP) Device

Amit Chopra, M.D.1; Piyush Das, M.D.2; Kannan Ramar, M.D.1; Bruce Staats, M.D., F.A.A.S.M.1; Erik K. St. Louis, M.D., F.A.A.S.M.1
1Center for Sleep Medicine, Mayo Clinic, Rochester, MN; 2Department of Sleep Medicine, Cleveland Clinic, Cleveland, OH

Complex sleep apnea syndrome (CompSAS) is characterized by predominant obstructive sleep disordered breathing with evolution of central disordered breathing following exposure to nasal continuous positive airway pressure (CPAP) therapy in obstructive sleep apnea (OSA) patients. We report a case of CompSAS associated with use of a nasal expiratory positive airway (nEPAP, Provent) device. We therefore recommend obtaining objective sleep data to confirm treatment effectiveness of the nEPAP device for OSA prior to long-term prescription. Further research is warranted to understand the underlying pathophysiological mechanisms and risk factors associated with CompSAS.


Chopra A, Das P, Ramar K, Staats B, St Louis EK. Complex sleep apnea associated with use of nasal expiratory positive airway (nEPAP) device. J Clin Sleep Med 2014;10(5):577-579.

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