A physiologic mechanism of action study (abstract 0591), by Dennis Hwang, MD, and colleagues, including David Rapoport, MD, Associate Professor of Medicine, New York University School of Medicine, found that PROVENT Therapy produced marked improvement in sleep-disordered breathing in 8 of 11 treated patients with some residual sleep-disordered breathing during REM sleep.¹ Of the 8 patients, 5 demonstrated a complete response and 3 a partial response.

“These positive efficacy findings were associated with positive and prolonged intranasal pressure when the patient exhales,” said Rapoport. “We believe it is this pressure, known as autoPEEP (positive end-expiratory pressure), which keeps the airway open until the patient inhales, may increase the end-expiratory lung volume, and thus creates a pull on the trachea and upper airway. This is how PROVENT Therapy prevents apneic episodes and helps patients with sleep-disordered breathing.”

In the 8 responsive PROVENT Therapy patients, end-expiratory intranasal pressure increased to a range between 11 and 26 cm H2O during periods of complete success, whereas the nonresponders’ intranasal pressure ranged from 3 to 10 cm H2O, with lowest pressures at the time of failure of treatment. This suggests that the increased pressure could have been the mechanism of action that keeps the airway open until the patient inhales.¹

1. Hwang D, Patel A, Chen G, Ayappa I, Rapoport DM. Nasal EPAP—Physiologic Mechanism of Action, June 9, 2009, poster presentation at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies. Abstract 0591.