Obstructive Sleep Apnea
Sleep apnea is a potentially serious sleep disorder that causes breathing to repeatedly stop and start during sleep and may result in insufficient oxygen to the brain and the rest of the body. In obstructive sleep apnea (OSA), the most common type of apnea, the soft tissue in the back of the throat collapses when you fall asleep, which blocks the airway.
For mild cases of obstructive sleep apnea, a doctor may simply recommend lifestyle changes that include the following:
If these measures don't improve sleep or if apnea is moderate to severe, then a doctor may recommend other treatments.
Continuous Positive Airway Pressure (CPAP) therapy is the most prescribed method by doctors to treat OSA. A description of the equipment, how it functions and features to consider when selecting a CPAP machine to follow.
Before purchasing or renting any CPAP therapy equipment consult a doctor for a diagnosis and therapy recommendation.
CPAP therapy uses a machine that delivers pressurized air to the throat preventing the airway from collapsing during sleep. The device consists of three parts:
While there are many different types of CPAP machines on the market, they all fall into one of the following three categories:
The basic CPAP machine is often referred to as a “fan in a box.” Without any special features, it simply allows patients to get a good night’s sleep by providing continuous pressurized air to the throat airway.
Auto CPAP Machine
Doctors may recommend an Auto CPAP machine for a patient who requires fluctuating air pressure during sleep. While the basic CPAP machine provides only one pressure, the Auto CPAP machine has the ability to measure the pressure continuously and adjust so the correct amount of pressure to keep the airways open.
The bi-level positive airway pressure (BiPAP) machine offers sleep apnea sufferers two levels of air pressure. While the Basic and Auto CPAP machines continuously apply the same pressure whenever you inhale or exhale, the BiPAP machines find the optimal air pressure and flow based on a patient’s breathing. A high-pressure air flow is applied from the machine when the patient inhales and a lower pressure when exhaling.
CPAP Machine Manufacturers
For each CPAP machine category, there are many different manufacturers, features, and options to consider. These are the most important:
The selection of a CPAP mask may be the most important factor in determining the success of a sleep apnea therapy. It is worn at night over the nose only or both the nose and mouth. Several style options are available, providing the patient with the opportunity to find a model that is comfortable and functions correctly.
To select the appropriate mask, the patient should seek the advice of a sleep therapy doctor. Once selected, a trial period is recommended to assure proper function. CPAP machines may be rented, or purchased on a trial basis with an option to change equipment until the right one is found.
Here are the most common mask types and their characteristics.
Nasal CPAP Masks
The Nasal CPAP mask has a triangular shape that covers the nose only and is held in place by a four-point headgear. Made of silicone, gel, or cloth, it is available in a wide variety of sizes and shapes.
Full-Face CPAP Mask
The Full-Face CPAP mask has a triangular shape that seals around the nose and mouth and is held in place by a four-point headgear.
Nasal Pillow CPAP masks do not cover the mouth and use a soft pillow to seal around the base of the nostrils. They are a favorite among sleep apnea patients who want an interface that is smaller in design and results in less facial interference.
Nasal Prong Mask
The Nasal Prong CPAP Mask delivers air inside the nasal openings of the nose and is held in place by headgear.
The Hybrid Full-Face CPAP mask provides the functionality of a full-face mask but without the bulk normally associated with these types of masks. A Hybrid not only uses nasal pillow seals at the nostril openings but it also combines this with an oral cushion that seals around the mouth.
The Oral CPAP mask uses an oval cushion to seal around the mouth and delivers air through two inlets inside the mask. An inside flap rests between the teeth and lips and a second flap curls over the lips to keep the mask stable.
Total Face CPAP Mask
The Total Face CPAP mask is the only mask that uses a large oval to seal the entire face including the nose, mouth, and eyes. The design is ideal for individuals who experience air leakage with a Nasal or Full-Face mask.
Cleaning and Maintenance
Proper cleaning and maintenance of CPAP equipment are essential to the success of any sleep disorder treatment program. Just a few minutes per day should be sufficient to keep all the components in good condition and the machine functioning efficiently. The following procedures are recommended for all types of CPAP systems.
CPAP Humidifier Cleaning and Replacement
Most CPAP machines sold today include a heated humidification system. This type of system minimizes incidents of morning dry mouth as well as keeping your nasal turbinates moist so they do not become irritated and inflamed. However, the humidification chamber needs to be cleaned out daily to prevent bacteria build-up as well as calcification.
CPAP Mask Cleaning and Replacement
Most the CPAP masks on the market today are made from hypoallergenic, latex-free, silicone cushions designed to be non-irritating and comfortable. Silicone, however, doesn't last long without proper care and it can break down quicker than expected. Here are some tips on CPAP mask cleaning and replacement:
CPAP Filters Cleaning and Replacement
Filters are located at the air inlet near the back of the CPAP machine. Most machines have a disposable white paper filter and some have an additional non-disposable gray filter. Filter cleaning recommendations:
Most insurance policies cover CPAP, however, deductibles and copayments for medical equipment may be different from office visits or prescriptions. Medicaid does cover CPAP equipment, with authorization. Supplies are covered separately and vary by state. Patients should contact their insurer to find out insurance policy specifics.
Obstructive Sleep Apnea can be treated for most patients with CPAP therapy. Proper equipment selection is essential and in particular, the choice of mask is critical to the therapy’s success. A comfortable and efficient mask, one that is maintained correctly will encourage the patient to follow the recommended program and result in a restful night’s sleep.