Which of the following would be a contradiction of PAP therapy?

Which of the following would be a contradiction of PAP therapy?

• A. Tracheostomy
• B. GERD
• C. Rhinitis
• D. COPD

Answer: (A)

PAP therapy is designed to deliver pressurized air through the upper airway via a mask to keep it from collapsing during sleep. A tracheostomy bypasses the nose and mouth, so the pressurized air from a nasal/oronasal PAP interface wouldn’t effectively reach the lungs and could create leaks around the stoma or other issues. Because of this, a tracheostomy is incompatible with standard PAP therapy. The other options aren’t contradictions. GERD often coexists with sleep apnea, and PAP therapy can still be used with appropriate management. Rhinitis can be accommodated with humidified air, nasal sprays, or a different mask, so it isn’t a barrier. COPD is not a contradiction; PAP, including BiPAP, is commonly used in COPD patients to support ventilation, though individual factors determine suitability.

PAP therapy is designed to deliver pressurized air through the upper airway via a mask to keep it from collapsing during sleep. A tracheostomy bypasses the nose and mouth, so the pressurized air from a nasal/oronasal PAP interface wouldn’t effectively reach the lungs and could create leaks around the stoma or other issues. Because of this, a tracheostomy is incompatible with standard PAP therapy.

The other options aren’t contradictions. GERD often coexists with sleep apnea, and PAP therapy can still be used with appropriate management. Rhinitis can be accommodated with humidified air, nasal sprays, or a different mask, so it isn’t a barrier. COPD is not a contradiction; PAP, including BiPAP, is commonly used in COPD patients to support ventilation, though individual factors determine suitability.