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Why PRO•PAP CPAP Pillow Is So Cool

The PRO•PAP CPAP pillow is a revolutionary new sleep pillow, specially designed for the CPAP patient to restore this mind-body relationship through quality sleep.


The PRO•PAP sleep apnea pillow is constructed from a high quality Tempurpedic®-type memory foam, and has a quilted Cool-Max® cover to help regulate body temperature and control perspiration. Elastic bands take the weight of the tubing off of the sleep apnea mask, while comfortably allowing the sleeper to change positions. PRO•PAP’s patented butterfly shape was designed specifically for the side-sleeping position. The orthopedic roll provides proper support for the neck, whether sleeping on the side or on the back. PRO•PAP was designed by a sleep apnea patient for the sleep apnea patient.

Obstructive sleep apnea (or OSA) is a sleep disorder in which there are multiple nighttime episodes of upper airway obstruction, causing blood oxygen saturation levels to fall and disruption of normal sleep architecture [1]. Over 40 million Americans suffer from a sleep disorder, and 20 million suffer from obstructive sleep apnea, making it as widespread as asthma [2].

Disruption of normal sleep causes increased problems with cognition and activates inflammatory processes thought to play a role in the development and progression of cardiovascular disease [3][4]. Moderate to severe OSA affects more than 1 in 5 adults in the United States [5]. Individuals with OSA are known to be at a large increased risk of all-cause mortality [6][7], increased hypertension, heart failure, cardiac arrhythmias, insulin resistance [3] glucose intolerance and a high frequency of type-2 diabetes [8].

The effectiveness of the side-sleeping, or lateral, position to reduce Obstructive Sleep Apnea (OSA) is well documented. Approximately one-half of all OSA patients are positional, with a majority of breathing abnormalities appearing in the back-sleeping, or supine, position [9].

OSA patients who sleep in the lateral position experience a marked reduction in the number of apnea-hypopneas [11], a reduction in the severity of Cheyne-Stokes respiration [12], a reduction in the apnea index by 50% [13], and a reduction in the upper airway collapsibility, independently of sleep stage [14]

Research studies affirm the effectiveness of Positive Airway Pressure (PAP) as the preferred treatment for patients with moderate to severe OSA [17]. Studies of the effect of PAP therapy show that OSA patients who consistently use their machines feel better and, as a result of the reduction of apnea and hypopnea episodes during sleep, encounter fewer complications of the disease [13]. However, in the long term, patient adherence to PAP therapy is poor. In PAP studies, the success rate of PAP therapy can be as low as 50% [13]. Factors such as mask discomfort and sleep position are the most common reasons given by patients that fail to maintain the compliance standard [18][19][20], defined by at least 4 hours of use per night on 70% of the days monitored [21].

A number of researchers have suggested that compliance with PAP therapy could be improved by combining it with a positional device. For example, Kim recommends that PAP compliance could be improved by developing a comfortable mask or by instituting changes in sleep posture [19]; Heinzer concluded, “that a combined therapy with a positional device should be considered in patients insufficiently treated with PAP” [22].

1. The American Academy of Sleep Medicine, http://www.aasmnet.org (2008).
2. NIH Publication, No. 06-5271, Nov 2005.
3. Caples, S.M., Gami A.S., Somers V.K., Obstructive sleep apnea, Annals of Internal Medicine 2005;
4. Shamsuzzaman, A.S., Gersh, B.J., Somers V.K., Obstructive sleep apnea: implications for cardiac and vascular disease, JAMA, 2003; 290:1906-14.
5. Wolk R., Shamsuzzaman A.S., Somers V.K., Obesity, sleep apnea, and hypertension, Hypertension, 2003, 42:1067-74.
6. Marshall N.S., et al, Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study, Sleep 2008; 31:1079- 85.
7. Young T., et al, Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort, Sleep 2008; 31:1071-8.
8. Meslier N., et al, Impaired glucose-insulin metabolism in males with obstructive sleep apnea syndrome, European Respiratory Journal, 2003; 22:156-60.
9. Oksenberg, A., Silverberg D.,Offenbach, D., Arons, E., Positional therapy for obstructive sleep apnea patients: A 6-month follow-up study, Laryngoscope, 2006 Nov;116(11):1995-2000
11. Oksenberg A., Positional and non-positional obstructive sleep apnea patients, Sleep Medicine, 2005;6:377–378.
12. Szollosi, I., Roebuck, T., Thompson, B., Naughton, M.T., Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration, Sleep, 2006 Aug;29(8):1045-51.
13. Grote, L., Hedner, J., Grunstein R., Kraiczi H., Therapy with nCPAP: Incomplete Elimination of Sleep Related Breathing Disorder, European Respiratory Journal, 2000; 16:921-7.
14. Penzel, T., Effect of sleep position and sleep stage on the collapsibility of the upper airways in patients with sleep apnea, Sleep, 2001 Feb 1;24(1):90-5.
17. Gay, P., MD, Weaver, T., RN, CS, FAAN, Loube D., MD, Iber, C., MD, Evaluation of positive airway
pressure treatment for sleep related breathing disorders in adults, Sleep, Vol. 29, No. 3, 2006
18. Engleman H.M., Wild M.R., Improving CPAP use by patients with the sleep apnea/ hypopnea syndrome, Sleep Medicine, Rev. 2003 Feb 7;(1):81–9.
19. Kim, J., Kwon, M., MD, Compliance with Positive Airway Pressure Treatment for Obstructive Sleep Apnea, Clinical & Experimental Otorhinolaryngology, Jun 2009;2(2): 90-98.
20. Wolkove, N., et al, Long-term compliance with continuous positive airway pressure in patients with obstructive sleep apnea, Canadian Respiratory Journal, 2008; 15 (7): 365-369.
22. Heinzer, Raphael C., Positional therapy for obstructive sleep apnea: An objective measurement of patients’ usage and efficacy at home, Sleep Medicine, 13 (2012) 425–428.

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