Continuous Positive Airway Pressure (CPAP)
 
 

Continuous Positive Airway Pressure (CPAP)

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CONTINUOUS POSITIVE AIRWAY PRESSURE

Obstructive sleep apnea and snoring occur when tissues of the upper airway, the tongue and the throat relax during sleep. Relaxation of these tissues and muscles causes an obstruction and vibration of the airway, making breathing difficult and noisy. This is called snoring.

Eventually, the tissues of the airway collapse resulting in a breathing pause or apnea. As a result, you must work harder to breathe and oxygen in the blood is reduced. Reduced oxygen in the blood tells the brain to awaken you, which temporarily interrupts sleep. This cycle repeats itself many times during sleep causing you to wake up in the morning feeling sleepy, possibly with a morning headache, because of poor brain oxygenation during sleep.

To treat obstructive sleep apnea, your healthcare provider may suggest an air pressure device known as Continuous Positive Airway Pressure, or CPAP (pronounced “see-pap”).

CPAP is the most effective treatment for obstructive sleep apnea. This treatment involves wearing a mask over the nose and sometimes over the mouth and nose. The mask is connected to a flow generator by six feet of corrugated tubing. The flow generator creates a predetermined air pressure that prevents the tissues of the airway from collapsing. The open airway prevents snoring and sleep disruption. The CPAP device does not breathe for you, but rather keeps your airway open so that you are able to breathe.

It is important to note that CPAP is regular room air and not the delivery of oxygen. Sometimes oxygen is used in addition to CPAP for those with poor oxygen levels even after the obstructive sleep apnea has been treated. Remember, CPAP is a treatment for snoring and obstructive sleep apnea. It is not a cure. You will need to use it all night - every night - to realize the benefits of this treatment.

Symptoms of Your Diagnosis

Obstructive Sleep Apnea is most commonly seen in overweight people. Symptoms include loud snoring, audible breathing pauses usually heard by the sleep partner, daytime sleepiness, thrashing around in bed, morning headaches, a dry mouth in the morning and gasping for breath at night. Loud snoring and daytime sleepiness are the most common complaints because your partner’s sleep is disturbed by your snoring and you are probably not functioning at the level you are accustomed to as a result of being sleepy during the daytime.

Obstructive sleep apnea can also lead to memory problems as well as difficulty concentrating and thinking. Anxiety and depression are frequent symptoms, as are irritability and aggressive behavior. Simultaneous medical illnesses can be associated with obstructive sleep apnea, such as: heart attack, stroke, high blood pressure, depression, sexual dysfunction or lack of desire. There is a substantial increased risk of an accident on the job or while driving.

Tips for Using CPAP

  • Because you will not be accustomed to wearing a mask during sleep prior to your first night on CPAP therapy, do not be frustrated if you only use CPAP for a limited amount of time during the first two weeks.
  • If your mask interface causes discomfort or does not fit properly, talk to your healthcare provider about a different mask interface system. Many mask interface systems exist in the marketplace some of which fully encompass the nose. Others encompass both the mouth and nose (for mouth breathers) and still others do not encompass the mouth or nose, but fit into the outside of the nasal passages.
  • An in-line humidifier is often necessary to relieve nasal dryness and a dry mouth. If you wake up with a dry mouth or dry nose, or with the mask interface on the bed or floor, you are probably suffering from dryness from the air blowing into your nose and upper airway. Humidifiers, especially heated humidifiers, work to add moisture to the tissues of the nose and soft palate making the use of CPAP more comfortable.
  • If you suffer from allergies or a poorly working nose (such as a deviated septum), contact your healthcare provider to discuss the use of nasal steroids, nasal saline, and possibly corrective nasal surgery. CPAP requires a clear nasal passage and does not work well without one.

What to DO

  • Once diagnosed with obstructive sleep apnea, the first step is to use CPAP in your home for a one to two month trial. The majority of insurance companies pay for this and usually require a one to two month trial before they purchase this device.
  • Stay in contact with your healthcare provider about your use of CPAP. Discuss any problems and benefits to wearing this therapy.
  • Find a support group dedicated to the treatment of obstructive sleep apnea, such as “Alert, Well and Keeping Energetic” (A.W.A.K.E) groups.
  • Wear the CPAP every night for at least six hours before you decide to look at other options. You will not see benefits with less than six hours of use on a nightly basis.
  • You should wear CPAP at all times. If you travel, these devices now come with a carrying case and are approved medical devices by the Federal Aviation Administration (FAA). Call the airline’s medical desk to determine if they require a letter of medical necessity.

What NOT to DO

  • You should not continue to use your mask system if you develop sores on your face or if you have an ill-fitting mask.

Things to Remember

  • Select the CPAP device and mask system that will meet your needs and lend the greatest chance for success. Many CPAP devices and mask systems exist, because different shaped noses exist as well.
  • Though CPAP therapy is the best treatment option, many other treatment options are available as well.
  • Try to lose weight, stop smoking and sleep on your side.
  • Every two years or if you lose or gain weight, a follow up sleep study is necessary to ensure that your CPAP pressure level is adequate.
  • Follow your healthcare provider’s treatment advice.

What We Have Learned

  1. Obstructive sleep apnea occurs when tissues in the throat and airway collapse.
    True or False
    Answer: True
  2. The most effective treatment of obstructive sleep apnea is surgery for a deviated septum.
    True or False
    Answer: False
  3. Obstructive sleep apnea is most common in overweight people.
    True or False
    Answer: True

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