CPAP is a acronym for Continuous Positive Airway Pressure. It is the standard of care for the treatment of Obstructive Sleep Apnea (OSA). A CPAP involves the use of an adjustable blower unit connected to a small mask usually covering the nose. A nasal CPAP acts as a "pneumatic splint" by increasing pressure in the oropharyngeal airway, allowing air to flow in and out easily, thereby reducing the work of breathing. Consequently, microarousals due to apneic events are eliminated, sleep is less disrupted and patients feel more refreshed and energetic. Patients typically adapt very quickly to CPAP, and most patients report sleeping better and feeling better the next when using the device. Some patients may undergo an adjustment period lasting a few days to a few weeks, depending on how potential side effects are managed.
Nasal CPAP may help to:
- Improve your quality of sleep
- Alleviate your daytime sleepiness
- Increase your energy level
- Improve your memory
- Function more efficiently
- Increase your motivation
- Improve your job performance
- Prevent hypertension, heart attack and stroke
CPAP devices come with additional options such as:
- Humidifiers to minimize nasal congestion, dryness or burning
- Automatic adjustment to prevent leakage
- Ramp option to facilitate entry into sleep by starting with a lower pressure and allowing a build up to the prescribed pressure over a period of time
- A bi-level device has two prescribed pressures with a higher pressure during inhalation and a lower pressure that is activated when the patient exhales.
- Travel unit with suitcase, power cord and plug or voltage adapters for international travel may be needed for some units.
- Altitude adjustment may be automatically changed in some units. More pressure is typically needed at higher altitudes (such as traveling to Colorado). As a result, you should enquire with your home care company or your sleep medicine physician to determine if your unit makes this adjustment automatically if you are considering traveling to an area of higher altitude.
CPAP Side Effects and Comfort Level
Patients may report mask or pressure-related problems when using CPAP. Potential side effects include claustrophobia, nasal congestion, rhinitis or runny nose, sore eyes, headaches and abdominal bloating. Such side effects may, unfortunately, lead some patients to stop using their CPAP devices. However, it is important to note that most side effects are easily treatable with the proper intervention.
Although adherence to nasal CPAP is reported to be approximately 50% at the national level, our success at the Ohio Sleep Medicine Institute in maintaining patient compliance to nasal CPAP is well over 80%. One of the most important factors in predicting a patient’s ability to utilize CPAP is having the CPAP pressure at the appropriate pressure setting. If the pressure is too low, the patient will will have “breakthrough” obstructive breathing events during sleep. However, if the pressure is too high, the patient may fight with the device, have nasal congestion or mask leaks, and have more fragmented or choppy sleep. With the appropriate pressure setting, your likelihood of success with CPAP is greatly increased.
To increase your comfort and thereby your treatment adherence, it is essential to find a mask that fits your face or nose correctly. Adjusting the humidifier setting is also very important, having the highest humidifier setting in the winter when the bedroom is typically very dry, and the lowest setting in the summer when it is naturally more humid. Maximizing adherence to nasal CPAP is very important for patients with obstructive sleep apnea Therefore, it is essential to work in partnership your sleep medicine physician and staff to find the best pressure, mask and device that fits your needs.
- Use sediment free or distilled water to prevent deposits with humidifiers.
- Clean and take proper care of your unit to prolong longevity and avoid contaminants such as as mold.
- Have your unit checked once a year to ensure proper pressure setting.
- Take advantage of the instruction, training and follow-up offered by concerned health care professionals.
- If you have severe sleep apnea, always have an extra mask and hose available for back-up.
- Choose a mask that fits properly. If it is too large or small, it will be uncomfortable.
- Nasal congestion can usually be relieved with proper heated humidification. Most new CPAP units now come included with a heated humidifier.
- Never wear a mask overtightened as it will be uncomfortable and cause discomfort. An overtightened mask may also cause more leaks since the inflatable membrane of the mask may not be able to maintain a proper seal.
- -If air leaks around the mask, you may need a new mask or change to a different mask.