DOES THE SEVERITY OF SLEEP APNEA MATTER?
The severity determines the appropriate treatment options. In the case of CPAP treatment, CPAP is considered ‘gold standard’ for all severity levels. In other words, CPAP effectively treats all severity levels.
As a general guide there is a greater range of alternative non-CPAP treatment options available to those with milder severity levels. CPAP is typically recommended as first line treatment for obstructive sleep apnea.
Diagnosed with moderate to severe and severe obstructive sleep apnea CPAP is the recommended choice of treatment in combination with other support therapies.
The sleep specialist’s recommendations on a sleep test report will indicate treatment options. The sleep test provider can also discuss treatment options and/or you may wish to arrange a consultation with your doctor.
WHAT IS CPAP?
CPAP is the acronym for Continuous Positive Airway Pressure.
CPAP treatment falls under the MedTech category and consists of a small device that blows air via a small nose mask or nose and mouth mask connected together by a tube.
CPAP is generically used as a term when discussing all device types treating obstructive sleep apnea.
The CPAP device uses room air to generate a flow of air that is also referred to as positive pressure. When breathing in this positive flow of air it creates a splint effect in the airway, this holds the airway open to prevent airway collapse.
By holding the airway open during sleep means the person who once suffered from partial or complete airway obstructions and disrupted sleep as a result can now sleep uninterrupted and gain the benefits from having improved quality of sleep.
A CPAP device is programmed to deliver a fixed pressure airflow setting throughout sleep.
WHAT’S THE DIFFERENCE BETWEEN APAP AND CPAP?
APAP is the acronym for automatic airway pressure.
Both APAP and CPAP deliver positive airway pressure but where the difference lies is in that an APAP device has a built in algorithm to assess airway patency and change device pressure according to airway needs.
The algorithm intelligence of an APAP device constantly assesses the airway to determine when to increase and decrease airflow pressure.
Breathing with APAP can be easier due to an APAP delivering overall lower levels of pressure compared with CPAP.
CPAP is set to a constant fixed set pressure level. The fixed pressure is set to meet the person’s pressure needs across the entire night. This means the pressure setting therefore needs to be set to the person’s highest pressure needs. When the higher pressure is not required the CPAP device will continue to deliver the same fixed pressure.
During sleep airway patency with obstructive sleep apnea (OSA) can be influenced by the different sleep stages. During REM sleep, known also as the deeper stage of sleep, typically causes more airway instability and likelihood of suffering from increased obstructions.
This is why pressure needs change throughout sleep.
Each manufacturer of APAP devices has their own unique algorithm designed to measure, analyse and interpret airflow with each breath. Determining how much pressure to deliver to keep the airway open and free of obstructions with the aim of delivering the lowest possible pressure. Specific response mechanisms when increasing or decreasing pressure so not to disturb sleep but ensuring the airway remains free of obstructions.
HOW TO DETERMINE WHICH SLEEP APNEA DEVICE IS BEST FOR ME?
In majority of cases the person diagnosed with obstructive sleep apnea decides whether CPAP or APAP is best for them.
When a person is diagnosed with central sleep apnea they are referred to a sleep specialist for clinical management and to determine type of device and settings. The sleep specialist therefore determines the type of sleep apnea device which is typically either CPAP or an adaptive servo-ventilation device.
Other influencing factors are price therefore affordability, a doctor’s prescription, government or insurance programs.
Discussions with your sleep clinic and/or doctor can also assist here.
CAN CPAP MAKE MY SNORING STOP?
Yes it can, which is great news and for many a welcomed relief.
Snoring is the audible sound of vibration in the airway. It’s also an indication of airway instability and airflow restriction occurring prior to a possible obstructive event (apnea event) or as a loud snorting sound post an apnea event as the airway clears.
When CPAP or APAP is not in use the snoring will return, therefore snoring is only resolved when breathing with the device.
CAN CPAP CURE SLEEP APNEA?
Yes and No.
Yes only when in use breathing with a CPAP type device and when the device is effectively treating the sleep apnea. This can be determined by the device nightly recorded data.
No because when CPAP treatment is not in use the sleep apnea returns.
HOW LONG DO I NEED TO USE CPAP FOR?
Treating sleep apnea is a lifelong commitment unless of course the sleep apnea resolves as a result of other interventions.
A sleep test without CPAP is the only way to determine if the sleep apnea has resolved. Important to note that should you be a CPAP user wanting to retest for sleep apnea the sleep test provider will likely advise about discontinuing CPAP for a specific period of time before taking test due to the residual effects from CPAP use.
HOW DO I START CPAP?
The sleep treatment provider will require a sleep test report or doctor’s referral to confirm a sleep apnea diagnosis.
You can start treatment as soon as you receive your paperwork and best not to delay as sleep apnea is a serious medical condition left untreated.
You can determine whether you would like to trial before purchase of equipment or alternatively you can purchase outright. The choice is yours. Influencing factors in this decision may include whether you want an in-clinic or online set up, accessiblilty to a sleep clinic should you prefer an in-clinic set up, feelings around use of trial equipment.
The early days of CPAP use varies from person to person, some take to it like a duck takes to water others a period of acclimisation. Either way commitment and persistence is required and typically within a few weeks it’s normal to begin being able to manage longer nights of use with the device. So in the beginning it’s not expected that you would manage the entirety of the night but rather a shorter period that gradually increases with use.
An experienced support person is essential in the process of CPAP acclimisation.
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About Catharine Nixon