Sleep Apnea Treatment Options: CPAP/AutoPAP Machines
More than 18 million Americans are living with Obstructive Sleep Apnea. If left untreated, this sleep disorder disrupts functioning in daily life and can even lead to hypertension, heart disease, and mood and memory problems. Thankfully, there are effective treatment solutions, like the CPAP/AutoPAP equipment, that help restore regular breathing and reduce the risk of further medical complications.
The Science Behind Sleep Apnea and PAP Treatment
As you sleep, your body becomes relaxed. In patients with sleep apnea, the muscles in the throat also relax, oftentimes blocking the upper airway. Despite trying to breathe, this blockage halts the exchange of air, causing a pause in your breathing. You may wake up gasping for air or you may snore loudly as your body attempts to resume breathing. When your breathing is interrupted throughout the night, your body becomes starved of oxygen and you are unable to achieve the restorative sleep that your body needs. This, in the long-term, can lead to other medical conditions, such as hypertension and heart disease. The lack of sleep can affect your memory, concentration and your ability to perform regular daily activities.
The Purpose of PAP Treatment
The goal of sleep apnea treatment is to keep the airway open to allow for regular breathing. The most common and effective method of treatment is CPAP/AutoPAP. These machines provide positive airway pressure (PAP) to the upper airway through a mask. This positive pressure keeps your airway open and allows for regular breathing. A sleep study done in a sleep center or a home sleep test can determine the pressure you require to keep your airway open during sleep.
CPAP or AutoPAP is one of the most effective treatments available to reduce apnea events during the night and improve daytime sleepiness and function. A 2001 study looked at the effectiveness of regular CPAP treatments and how it affected daytime function. The results showed that the group receiving optimal CPAP treatments experienced a much greater improvement in the level of daytime sleepiness and general productivity. Having a device that keeps your airway open and allows for uninterrupted sleep lets your body recharge and gives you a fresh start to a new day.
How a CPAP System Works for Sleep Apnea
Developed in the early 1980s, the continuous positive airway pressure (CPAP) machine uses a blower to deliver fixed air pressure through a mask a person wears throughout the night. This pressure is designed to counteract the force of the throat tissue that relaxes and blocks the airway, leaving the airway open for breathing.
Air Pressure Works as a Splint for Your Airway
CPAP equipment begins with the machine that blows pressurized air through a tube attached to a mask. During a sleep study the ideal pressure setting is determined and set. Some newer CPAP machines use algorithms and special pressure sensors to determine the best pressure for a person. PAP pressure is measured in centimeters of water or cmH2O. This measurement stands for the amount of pressure a column of water would exert against a container.
During sleep, the CPAP machine provides a constant stream of air to the back of the throat. This constant air stream acts as a splint and keeps the airway open, allowing a person to inhale and exhale without obstruction.
The Right Pressure Setting Makes all the Difference
Most people require CPAP pressure ranging from 6 to 14 cmH2O. The pressure you need should be just enough to keep your airway open. If the pressure is too low, you will continue to experience breathing interruptions. If the pressure is too high, breathing may be difficult, or you could experience nasal congestion. Pressure needs can change over time and if you notice that you are experiencing sleep apnea symptoms or are struggling to breathe and use the CPAP machine, you may need to speak with a health professional about changing your pressure.
One of the most common problems patients experience with a CPAP is overcoming the continual pressure flow while exhaling. Many new CPAP machines, called AutoPAP machines, have overcome this issue with sensors that detect exhalation and temporarily reduce the airflow pressure.
How an AutoPAP Works for Sleep Apnea
AutoPAP, or APAP, machines work slightly different than a traditional CPAP machine. Also called automatic titrating continuous positive airway pressure, these machines deliver air pressure that is set within a range of high and low pressures, adjusting the pressure flow as needed. Machines run with a pressure range between 4 and 20, though this range can be tightened by a physician and run with a tighter window around what your determined CPAP pressure would be.
Why Choose an AutoPAP over a CPAP?
As you sleep, changes in position, such as lying on your back, can cause an increase in the risk of tongue or throat obstruction. This machine senses the need for increased pressure and will adjust accordingly. An AutoPAP machine also adjusts for things like increased nasal congestion from colds or allergies. Increased sinus congestion can worsen apnea episodes and would require increased air pressure. Things like alcohol or medications with a sedative effect can increase deep sleep and apnea events. The machine would sense these needs and adjust the pressure as needed.
Choosing the Right Mask for You
Whether you choose to use a CPAP or an AutoPAP machine, your mask is where the air pressure is delivered, so finding the right mask for you is essential to making sure you are comfortable with your sleep apnea treatment. Masks come in three main styles.
Traditional Nasal Masks
Traditional nasal masks are triangular in shape and cover the nose. They have a hard, outer frame and a soft cushion that rests against the face. Many models also have a forehead brace that sits just above the eyebrows. This mask works best for those that breathe through their nose and are able to keep their mouth closed during sleep. People with a narrow nose bridge or a short face structure may experience difficulty with this mask and notice air leakage into the eyes.
Nasal Pillow Masks
Nasal pillow masks are another good choice for people who sleep with their mouth closed but are looking for a less cumbersome mask. This is also a good option for those with a narrow nose bridge or short face. The nasal pillow is a soft pillow-like piece that sits just below the nostrils and is held in place with a head strap.
Full face masks are designed for people that breathe through their mouth. This mask is made with a hard, outer shell with soft cushions against the face. It is a full-face mask, covering both the nose and the mouth.
When choosing the right mask for you, it is a good idea to try them all on and find what works best for you. Often, during a sleep study, your technician will have you test each mask type. Most manufacturers offer size gauges for each mask, but you must also consider face shape and facial features. Things like the length and width of the nose can affect how your mask fits. Once you find a good fit, be sure to adjust the mask before sleep to ensure the fit is tight enough to maintain air pressure while still comfortable enough to sleep.
Find the Machine and Mask That You are Comfortable With
You and your physician or technician will work together to find the right machine and mask for you. It is important that you ask questions and really know and understand your machine, as well as find a mask you are comfortable with. Getting used to a CPAP or AutoPAP machine can take time but wearing it every night is essential for treatment.