What should the RT do if a patient on nasal CPAP continues to exhibit obstructive apneic events?

When a patient on nasal CPAP continues to show signs of obstructive apneic events, the best course of action is to increase the CPAP pressure. CPAP, or Continuous Positive Airway Pressure, is designed to keep the airways open by providing a steady stream of air at a set pressure. Increasing the CPAP pressure can help ensure that the airway remains patent during sleep, specifically overcoming any resistance caused by obstructive events.

Obstructive sleep apnea occurs when soft tissues in the throat collapse and block the airway during sleep, and higher pressure can prevent this collapse by providing the necessary support to maintain airway patency. By increasing the pressure, the risk of obstruction can be mitigated, leading to improved airflow and reduced apneic episodes.

In contrast, decreasing the CPAP pressure might exacerbate the situation by allowing more airway collapse. Switching to BiPAP therapy, which offers two levels of pressure, may be considered if CPAP is insufficient, but typically an initial step would be to increase the pressure before changing modalities. Likewise, changing the patient’s position could help in some cases, particularly for positional obstructive sleep apnea, but it is not as direct or effective a response as adjusting the CPAP pressure. The direct correlation between