Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnea (OSA). Over the past 20 years, the indications for prescribing CPAP for sleep-related breathing disorders have expanded to include a majority of the adult population. CPAP is purported to reduce blood pressure, cure headaches, improve memory, and reduce weight. Unsubstantiated claims surrounding the use of the machine include promotions at work, improving your hairline, and making your car run faster.
The problem is, the threshold for diagnosing sleep apnea is so low that a majority of the adult male population will qualify as having this "disease." If you're a man over 60, your pretest probability for having OSA is close to 100%. The data for CPAP improving daytime symptoms for patients with moderate to severe disease, when hypopnea scoring requires desaturation, is quite strong. Outside this scenario, CPAP as a "cure-all" has far less support.
For example, let's look at CPAP as a therapy for atrial fibrillation (AF). For more than a decade, the cardiologists at my institution have been sending every one of their patients with AF to sleep medicine for polysomnographyAF is most common in older persons, and OSA prevalence in this group is close to 100% using modern sensors and the American Academy of Sleep Medicine (AASM) recommendation to
