Why are only about 50% of obstructive sleep apnea patients CPAP adherent? Patients who express trouble with their pressure settings have their CPAP expiratory pressure dropped—a lessening of the pressure level during exhalation—via an expiratory pressure relief feature available on many of today’s devices or a ramp feature, which drops both inspiratory and expiratory pressure together for about 30 minutes before gradually increasing both to the prescribed pressure. “And in retrospect, we made a mistake.”A New (Old) Theory About CPAP PressuresToday’s positive airway pressure devices for obstructive sleep apnea therapy offer relief from the air pressure during expiratory pressure. Though it sounds counterintuitive, the perspective that a lower inspiratory positive airway pressure (IPAP) and higher expiratory positive airway pressure (EPAP) can treat obstructive sleep apnea is not actually new. In fact, React Health CPAPs are now part of clinical trials to see if positive airway pressure therapy should be delivered differently.