Untreated, sleep apnea can result in a serious medical condition with such accompanying health issues as hypertension, chronic fatigue, and a myriad of cardiovascular problems. Treating sleep apnea with CPAP has been the preferred choice of physicians and sleep disorder specialists, as CPAP is almost 100% effective when used as directed. However, many patients find this therapy so uncomfortable that they either discontinue its use, or use it only intermittently.
Sleep Apnea CPAP
Most sleep apnea CPAP candidates suffer from obstructive sleep apnea, but there are two other less common types: central and complex. While obstructive sleep apnea happens due to the relaxing of muscles in the back of the throat resulting in blocked airflow, heart disease or stroke is the most common cause of central sleep apnea, and those with complex sleep apnea have problems with breathing rhythms. It’s important to be properly diagnosed, as symptoms of all three types overlap, and require different types of treatment. However, for obstructive sleep apnea, a continuous positive airway pressure (CPAP) machine is most often prescribed.
How CPAP Machines Work
These machines are small and fit easily on a bedside table. A flexible tube is connected to the machine at one end, and to a mask at the other. The mask fits over the patient’s face, and is held in place, or “sealed” by straps, or other headgear. When the machine is turned on, a pressurized airflow comes through the tube into the mask, and acts as a virtual “splint” to keep the airway into the throat open during sleep. Newer models proved heated and humidified air, battery back-up functions, and therapy tracking software, which allows patients to track the progress of their therapy.
Problems with CPAP
The sleep apnea CPAP patient must use the machine and wear their mask every night, all night long, as CPAP is only a temporary treatment. Unfortunately, this is the problem that most individuals have with CPAP, and many patients wear their mask for fewer than four hours per night. In point of fact, discomfort is the primary reason given for patient treatment failure. Some patients unconsciously remove the mask while sleeping, or are unable to keep the mask in place due to changing sleep positions. Additionally, many report other problems, such as eye and nasal irritation, sore throats, and claustrophobia.
APAP Machines
Aside from the mask, one of the major comfort issues for sleep apnea CPAP patients is air pressure. CPAP machines are adjusted at setup by a technician to blow one straight air pressure, which can be uncomfortable during exhaling. An automatic positive airway pressure (APAP) machine adjusts automatically to blow only the minimum amount of pressure needed to keep the patient’s airway open during sleep, and this adjustment happens breath by breath as needed, so that the machine provides the optimal pressure required. Also, APAP machines usually offer more comfort features and additional therapy tracking information.
BPAP Machines and Oral Appliances
Sleep apnea CPAP patients also benefit from a bilevel positive airway pressure (BPAP, BiPAP, or VPAP) machine. These machines function by providing a high-pressure airflow during inhaling, and a lower pressure when exhaling. Some may also benefit from the use of an oral appliance, and can consult with their dentist for an oral device that is designed to keep the throat open while sleeping. Although CPAP is usually more effective, many find these devices are more comfortable to use, particularly in cases of mild sleep apnea. However, oral appliances need to be checked for fit every six months, and afterward according to the dentist’s recommendations.
CPAP has long been the favored treatment for sleep apnea, but its effectiveness is reduced when patients refuse to use it, or use it improperly due to discomfort. However, working with different types of machines and devices can result in an improved level of comfort and an increased level of effectiveness.
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