What is CPAP
By Tom Hoffmann
Sleep Study Technician
Continuous Positive Airway Pressure or CPAP is the choice of treatment for many people who suffer from obstructive sleep apnea (OSA). A CPAP device includes a small lightweight machine, tubing, nose mask, and headgear.
Who needs CPAP?
OPAP is used to treat breathing disorders during sleep. People with central, mixed, and the more common obstructive sleep apnea may all benefit from CPAP therapy.
How does CPAP work?
During sleep, muscles in the airway relax allowing collapse and any excessive tissue in the throat, such as tonsils, adenoids, tongue, or the uvula to block the airway. This system gently delivers machine-generated air into the airway through a nasal mask.
This air is positive pressure and acts as a splint to keep the airway open, thus eliminating obstructions. This provides immediate relief to OSA sufferers by providing uninterrupted breathing and sleep. Another mode of treatment is called Bilevel therapy. This also involves positive pressure but at a different settings on inspiration and expiration. There is a higher pressure on inspiration which prevents obstructions and facilitates airflow into the lungs. On expiration there is a lower pressure that allows passive, easy expiration while maintaining a patent airway.
What are the side effects or complications of CPAP?
- Nasal and throat dryness: Adding a humidifier to the system can prevent dryness.
- Skin irritation from the mask: There are many different types of masks made from different material to help prevent skin hypersensitivity. Changing to a different mask could solve the problem.
- Pressure sores from the mask: This usually indicates that the mask is adjusted too tightly. The mask should only be snug enough to prevent leaks but loose enough to allow comfort. Different types and styles of masks should be explored to meet this goal.
- Eye irritation: This may also result from an improper mask adjustment. Proper mask size, type, and fitting may relieve this problem.
- Claustrophobia: CPAP education and a proper mask fitting can help to relieve anxiety and fear. Some CPAP units come with a "ramp’ feature that allows the pressure to start low and gradually over time increase to the pressure needed to eliminate apneas. By the time the pressure has increased to the prescribed level, the person is asleep and unaware of the pressure change. This option must be discussed with a Physician.
- Intolerance: People that are unable to adjust and acclimate to CPAP therapy may benefit from bilevel therapy, which more closely mimics respiration. This option must be discussed with a Physician.
What are the benefits of CPAP and how long is treatment needed?
The benefits of CPAP therapy are immediate but many times require a life-long commitment. CPAP is a treatment for apnea but not a cure. Apnea sufferers may try different treatment options, such as oral devices, medications, surgery, or weight loss but will probably not be cured by these options either.
These other treatments may improve the severity of the breathing disorder but CPAP has shown to be most effective. CPAP compliance, as with any other treatment, is the key to success for treatment of sleep apnea. It is imperative that people on CPAP use it every time they sleep.
Because CPAP immediately eliminates apneas and obstructions, there is an improvement in sleep quality and oxygen levels in the blood. Once this happens, the symptoms associated with sleep apnea may subside.
A person may feel rejuvenated, with an increased energy level, may not feel as fatigued throughout the day, and experience improved job/task performance. Treating sleep apnea may also decrease the risk for hypertension, heart attack, and stroke. CPAP may also benefit sleep partners, since they won’t be bothered by snoring anymore!
An evaluation, sleep study, and prescription are needed by a Physician to get started on CPAP therapy. Once all of this has been completed, the Physician will order the CPAP through a homecare company.
The company provides the CPAP system and a Nurse or Respiratory Therapist completes the initial set up and education. Follow up with the Physician and the homecare company is needed to assess the progress and success of treatment.
For more information about CPAP or other services offered by the Wayne Hospital Sleep Lab, call 547-5665.
Other sources for information about sleep apnea and CPAP therapy?
American Sleep Disorders Association
6301 Bandel Road
#101
Rochester, MN 55901
www.asda.org
National Sleep Foundation
729 Fifteenth Street NW
Fourth Floor
Washington, DC 20005
www.sleepfoundation.org