CPAP Therapy for OSA

The most common approach to treating those who suffer from Sleep Apnea is to use a CPAP machine which provides continuous positive airway pressure (CPAP).

What is a CPAP Machine?

Obstructive Sleep Apnea or OSA is a serious sleep disorder that results when the throat completely or partially closes which causes disordered breathing. You then snore or choke to intake air, which interrupts your sleep. While there are several treatment paths recommended for those who suffer from OSA, the most common approach is to use a CPAP machine which provides continuous positive airway pressure (CPAP).

The purpose of a CPAP machine is to keep your airway open. The machine filters air through a mask that funnels a constant stream of air into your airway. This constant stream of air creates enough pressure to maintain open airway and maintain proper oxygen levels. You can then sleep without waking up, choking or snoring.

Why You May Need CPAP Therapy

Proper breathing during the night is a powerful incentive for pursuing sleep apnea treatment, but there are many other reasons to treat this condition. Untreated sleep apnea is closely related to:

Heart disease, including congestive heart failure, irregular heartbeat, and coronary artery disease, as sleep apnea reduces blood oxygen levels.
Stroke, which causes a sudden loss in brain function due to ruptures or blockages in your blood vessels.

High blood pressure, which is the increased force of blood pushing on the walls of the arteries as the heart pumps blood. It is a precursor for both a stroke and heart attack.

Diabetes, which is an inability to produce or use insulin in the body, is linked to sleep apnea, glucose intolerance, and insulin resistance.

Many people with serious sleep apnea develop these conditions or these conditions recur if they stop using the mask for a time. Consistent use of the machine can prevent medical emergencies and decrease medical expenses.

Treating sleep apnea also helps keep you more alert and more able to concentrate, which reduces motor vehicle accidents and keeps you more productive on the job. Most users find themselves less apt to get depressed and have a better quality of life as a result. You will also snore less or more quietly, which will keep you from disturbing your household members.

PAP therapy can help you attain a better quality of life as you feel better rested.

How a CPAP Machine Works

There are many CPAP machine models that help you breathe. All consist of an air pump unit, a mask, and flexible tubing that connects the two and delivers pressurized air to the lungs. The tubing is long enough so that you can comfortably move around in bed, and the unit is quiet enough that it will not disturb you or a partner.

There are several types of PAP therapy machines that deliver air in a different manner.

  • APAP or auto-titrating positive airway pressure therapy. This machine raises or lowers your air pressure automatically during the night as needed.
  • BiPAP or bilevel positive airway pressure. This machine alternates pressure as you breathe in and out.
  • CPAP or continuous positive airway pressure. This machine keeps constant airway pressure.

PAP therapy masks vary; so choose the mask that is most comfortable for you. Here are some examples:

  • A nasal mask, the most common type of CPAP mask, covers only the nose.
  • A full-face mask covers both the mouth and nose. This mask works well if you breathe through your mouth when you sleep.
  • Nasal pillows are soft silicone and pillow-like inserts that slip gently into your nostrils to deliver the air along with a full-face mask. They can eliminate further air leaks.

The type of mask you use depends on your preference and your condition. Your DME company will work with you to help you determine the best mask for you, as well as the right amount of air pressure you need.

Here are some guidelines to help you choose the mask that best suits your needs and preferences

Alternatives to CPAP Therapy

While positive airway pressure is the treatment of choice for most people who suffer from sleep apnea there are both surgical alternatives and oral appliances available.

Potential Side Effects To Using a CPAP

Over time, using a CPAP machine can have minor side effects such as:

  • Dry nose and sore throat, which can be alleviated by using a humidifier that is attached to the machinery.
  • Nasal congestion, sneezing, and runny nose, which can be remedied with a prescription strained saline nasal spray, or over-the-counter nasal saline spray.
  • Skin irritation or strap marks from the headgear or nasal mask, which can be eliminated by choosing equipment that is comfortable for you and that features soft strap covers to reduce rubbing against your skin.

CPAP Myth and Fact Write up

1) CPAP only deliver oxygen to me when I sleep.

False.

Firstly, we need to know how a CPAP machine works to debunk the statement above. A CPAP is a device that takes in room air, converts it into pressurized air via a blower, and delivers it to the user through a tube and into the mask. The air that we breathe in is made up of a mixture of gases that includes: Nitrogen (~78%), Oxygen (~21%), Argon (~0.9%), Carbon Dioxide (~0.04%) and other gases.

Hence, the machine does not supply pure oxygen. Bare in mind, this device is different from an oxygen concentrator.

2) Feeling sleepier and not refresh after using a CPAP machine

There can be many factors why you might feel sleepier after using the machine. I’ll describe to you the different scenario that you might experience:

Scenario 1:

Adam is a new user to CPAP who has been diligently using the machine every night for at least 4 hours during his 1-month rental trial. He felt refreshed and has no issues with the machine during the first few days, but in the subsequent days, he started feeling sleepy and thought the machine was no longer working for him.

Explanation:

Adam might be experiencing a phenomenon known as REM rebound. This occurs in response to sleep deprivation or suppression of REM sleep caused by medication. In REM rebound, a person receives more REM sleep than usual, which can result in waking up feeling more tired. In Adam case, his sleep deprivation was likely due to sleep apnea. Through the use of CPAP machine, he achieved better quality of sleep leading to increased REM sleep. This temporary increase can make him feel more tired upon waking. However, this feeling of sleepiness typically resolves over time as the body adjusts to CPAP therapy.

Scenario 2:

Ben is a new user who struggles to use the machine throughout the night. He feels more tired due to the amount of time spent trying to fall asleep with the machine. Additionally, he frequently wakes up due to pressurized air leaking from the mask.

Advice:

There could be many reasons why you are unable to fall asleep with your device. It’s important to consult your sleep specialist for advice. Never give up—it takes time for CPAP therapy to work! The benefits of achieving good-quality sleep, which in turn improves your overall quality of life, far outweigh the initial challenges.

3) Will I become over-reliant on CPAP to the extent that I “forget how to breathe?”

The answer is nope.

The act of breathing is a subconscious, autonomous process controlled by our brain. The CPAP machine primarily delivers continuous pressurized air to keep the airway open during sleep. It does not control how you breathe or change your natural breathing pattern. Your breathing remains normal while using a CPAP machine,

4) CPAP can cure my sleep apnea

Unfortunately, there isn’t a cure for sleep apnea yet, but there are endless possibilities for the future! CPAP is a device that helps manage your condition but does not cure it. Think of it like how glasses help you see better while your vision issue (e.g., nearsightedness) still exists. Similarly, CPAP machines help you breathe better, resulting in good-quality sleep.

5) CPAP is only for people who are over-weight

False. This is a misconception. Sleep apnea can affect anyone, even those who aren’t obese. Being overweight is not the only factor contributing to obstructive sleep apnea (OSA). For example, in the Asian population, craniofacial features like smaller airway spaces or a retro-positioned mandible may also contribute to OSA.

Here’s a simple screening test you can do to assess your risk for OSA:

6) Will I suffocate using the CPAP machine when the power is down?

Nope you will not suffocate. The CPAP mask you use with the machine has small outlets for gas exchange. If the power goes out, your body will naturally wake you due to apnea events or the warm, stuffy sensation caused by the mask. You can also breathe through your mouth in such situations. So, don’t worry—there’s always a backup plan.

Image taken from Philips: https://www.philips.comsg/healthcare/product/HC0022130/dreamwear-nasal-cushion-under-the-nose-nasal-cushion

7) CPAP will restrict my movement when I sleep

Certainly not true, every CPAP mask has a swivelling part that allows user to toss and turn during sleep.

Image taken from Philips: https://www.philips.sa/en/c-e/hs/sleep-apnea-therapy/dare-to-dream.html

8) CPAP will be too noisy for me to sleep

Modern CPAP machine has evolved to be much quieter. Their average noise level is about 30 decibels (dB), which is comparable to the sound of whispering.