Using graduated in vivo exposure to treat a claustrophobic response to nasal continuous positive airway pressure: Hispanic male veteran associates nasal mask with gas masks worn during combat

Continuous positive airway pressure (CPAP) is the preferred treatment for obstructive sleep apnea syndrome because it safely and effectively reduces or eliminates nighttime upper airway obstruction. Unfortunately, CPAP adherence rates are low (30% to 40%). For some patients, a history of trauma contributes to nonadherence by triggering a claustrophobic response to CPAP. Exposure is the treatment of choice for anxiety-based responses, such as claustrophobia. Here, we provide the first demonstration of the successful use of graduated in vivo exposure to treat an individual experiencing a trauma-related claustrophobic response to CPAP.