Symptomatic improvement in patients with excessive dynamic airway collapse (EDAC) following initiation of positive airway pressure therapy

Excessive dynamic airway collapse (EDAC) is characterized by abnormal airway collapse during expiration, leading to symptoms such as breathlessness, cough, and reduced quality of life. Treatment options remain limited, and evidence-based guidelines are lacking. This prospective cohort study evaluated the impact of positive airway pressure (PAP) therapy on symptom burden in 23 patients with EDAC referred to a tertiary ventilation centre. Diagnosis was confirmed by computed tomography and/or bronchoscopy. Patients received nocturnal and ambulatory PAP, with symptom ratings and quality of life assessed at baseline and after three months. PAP therapy produced rapid and sustained improvements in breathlessness, orthopnoea, cough frequency, sleep quality, and quality of life, with significant differences in all domains ( p < 0.01). Adherence to nocturnal PAP was high. These findings suggest that PAP therapy is an effective symptomatic intervention in EDAC and support consideration of EDAC as an indication for PAP therapy in future clinical guidelines.