USE OF IN-VIVO DESENSITIZATION TO TREAT A PATIENTS CLAUSTROPHOBIC RESPONSE TO NASAL CPAP

Continuous positive airway pressure (CPAP) has proven to be a safe, ef fective treatment for sleep apnea patients. However, many patients dis play claustrophobic reactions to the CPAP nasal mask and cannot tolera te this treatment. The current report describes the successful applica tion of in vivo desensitization with a male apnea patient who initiall y failed CPAP therapy due to his claustrophobia. Over the course of tr eatment, the patient became able to tolerate using his CPAP device thr oughout his nocturnal sleep periods. Moreover, follow-up visits schedu led 6 months and again at 6 1/2 years after behavioral treatment showe d that the patient continued to use CPAP on a regular basis. It is con cluded that in vivo desensitization therapy may be useful in assisting claustrophobic patients to tolerate nasal CPAP. Results are discussed in view of the specific features of the case presented, and future ap plications of this behavioral procedure are encouraged.