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CPAP therapy in Sleep Apnea treatment

CPAP

Does your snoring keep your partner awake at night? Do you wake up feeling tired and even more irritable than before you went to bed? If so, you might have sleep apnea, which makes it difficult to breath while you’re asleep, keeping your from getting the rest that your body needs. There are several different treatments available for sleep apnea, including wearing a continuous positive airway pressure (CPAP) machine. This guide will tell you everything you need to know about sleep apnea and how CPAP treatment can help.

Sleep Apnea

A Good Night’s Sleep, sound sleep can be defined as that which occurs when the body is totally relaxed [and] vital functions like breathing and heart rate are slow. The overall quality of one’s life depends largely on their ability to get quality sleep. The most common symptom of bad sleep is a feeling of unrest or being constantly fatigued during waking hours—something that affects nearly everyone at some point in their lives. This fact makes it easy to see why consistently receiving high-quality restorative sleep is extremely important not only for you but for those around you as well. 

Sleep  Apnea is one of the most common sleep disorder across the globe. One out of every five Americans are suffering from some degree of Sleep Apnea. Causes of Sleep Apnea are Obstructive Sleep Apnea (OSA) & Central Sleep Apnea (CSA). OSA occurs when throat muscles relax too much or airway becomes blocked. CSA is caused due to failure of respiratory centers in brain. In both case there is a drop in oxygen level that disturbs sleeping causing snoring which is a symptom of sleep apnoea.

Sleep Apnea diagnosis: Sleep Test / Sleep Study / Polysomnograpgy

If you’re experiencing difficulty breathing while sleeping, a sleep test can tell you if you have sleep apnea. A sleep test is usually performed in a Sleep Lab during one of two different ways: polysomnography or respiratory polygraphy. During polysomnography (or sleep study), sensors are attached to your head, chest and legs as well as an oxygen sensor that clips onto your finger. The sensors measure many physical functions such as blood pressure, pulse rate, brain activity, heart rhythm and breathing patterns while asleep. Respiratory polygraphy measures breathing patterns through a mask worn over your nose throughout sleep.

This test is used to diagnose sleep apnea in patients who have never had a sleep study. A sleep study takes place at a special facility equipped for overnight recording of your brain waves (electroencephalogram or EEG), blood oxygen levels (oximetry), breathing patterns (polysomnogram) and other biological data while you sleep. The results of an overnight stay will help your doctor determine if you need treatment for obstructive sleep apnea or another form of sleeping disorder. It is generally recommended that you have a sleep study if you snore heavily, wake up several times per night choking or gasping for air, or are excessively tired during the day despite getting enough rest at night.

CPAP therapy is the most common and effective option for treating Sleep Apnea

Sleeping with a continuous positive airway pressure (CPAP) machine is a great way to stop sleep apnea. Basically, it works by pushing pressurized air into your throat so that you’re able to breathe easier while sleeping. A lot of people think they don’t need one because they feel fine during their waking hours—but if you’re someone who snores or feels excessively tired during waking hours, it could be a sign that you have sleep apnea and should speak to your doctor about using CPAP machine during sleep. 

How CPAP works

In a continuous positive airway pressure (CPAP) machine, compressed air is breathed in through a mask that covers your nose. This air then passes through a tube and is blown into your mouth. The compressed air helps keep your upper airways open so you can breathe normally throughout the night. If you have sleep apnea or are at risk for it, wearing a CPAP mask every night can improve how well you sleep and may even save your life by preventing cardiovascular events like heart attacks. 

Different types of CPAP mask

The success of a CPAP therapy largely depends on the mask you choose. Mask of different size & shape are available and they don’t fit with every patients. If you’re trying to decide on a new sleep apnea mask, or if you’re just not sure what kind of mask is right for you, here are some of your options. There are two main kinds of masks: nasal masks and full face masks. Nasal masks cover only your nose; they tend to be more compact than full face models and usually provide less overall support. However, people who get more movement in their jawline tend to prefer nasal masks because these aren’t as wide. Full face masks cover both your mouth and nose; these typically make it easier to breathe through your mouth when wearing a mask during sleep.

Nasal Pillow Mask

Nasal Pillow Mask

Pillow masks are among the most popular mask choices for CPAP users because of their minimal design. These are the smallest of the CPAP masks and rest on the user’s upper lip as it blows pressurized air through two soft nasal tubes that insert into the nostrils, and is secured by straps that go around the head.

Benefits of Nasal Pillow Mask:

  • The lightweight and minimal design are ideal for patients suffering from claustrophobia or those that simply feel uncomfortable with too much material touching their face.
  • Optimal for wearers who like to read or watch TV before bedtime, as it offers a better field of vision than many of the other mask types.
  • Allows the user to wear their glasses as there’s no material covering the bridge of the nose.
  • The direct airflow into the nasal passages reduces air leakage.
  • Good for active sleepers who toss and turn a lot.
  • Works best for users who have a lot of facial hair that may cause leakage in other mask types.
Drawbacks of Nasal Pillow Mask:
  • Often not ideal for patients with higher-pressure needs, as the airflow is very direct and may cause discomfort at higher pressure settings.
  • Some users find the direct air pressure leads to higher incidences of nasal dryness, and in some cases, even nose bleeds. 
  • Not ideal for mouth-breathers. If you’re not accustomed to breathing through your nose, using a nasal pillow may feel unnatural or uncomfortable. Although, if you’re a mouth-breather and really want to wear a nasal pillow, try using it in conjunction with a chin strap.

Nasal Mask

 

 

Nasal masks are triangular in shape and fit over the nose, covering the areas from the bridge of the nose down to the upper lip. They are popular among CPAP wearers because of the wide range of sizes and fits, making finding a perfect mask for any user very likely.

Benefits of Nasal Masks:
  • More natural airflow than nasal pillows as the delivered pressure isn’t as direct.
  • Better for higher-pressure settings than nasal pillows.
  • Many different styles cater to a wide range of facial structures and features.
  • If you move around a lot in your sleep or sleep on your side, the suction of the nasal mask helps keep it securely in place.

Drawbacks of Nasal Masks:

  • Much like nasal pillows, nasal masks are not ideal for mouth-breathers unless accompanied by a chin strap to keep the jaw closed.
  • Some CPAP wearers complain about irritation caused by the pressure of the mask resting on the bridge of the nose or the forehead supports of some models.
  • Not ideal for patients who frequently experience allergies or colds that cause blockage of the sinuses.
  • Not recommended for patients who have difficulty breathing through the nose from medical conditions such as a deviated septum, enlarged turbinates, or a collapsed or narrowed nasal valve.

Full Face Mask

 

CPAP full face masks cover the nose and mouth and all, or part, of the face with side straps that keep the mask in place. Some hybrid face masks cover the mouth but also have nasal prongs that fit into the nostrils like a nasal pillow.

Benefits of CPAP Full Face Masks:
  • Face masks are ideal for mouth-breathers and those that haven’t worked well with the nasal mask/chinstrap combination.
  • Ideal for patients who have nasal obstructions or frequent congestion due to allergies or cold symptoms.
  • Oddly enough, some claustrophobic patients have preferred the full face mask that covers the entire facial area, as the mask only touches the outsides of the face. Whereas the nasal pillows and nasal masks touch the upper lip and/or the bridge of the nose.
  • Works well for very high CPAP pressure settings because the wide surface area of the mask makes it feel as if the pressure is more tolerable and less direct than with other masks.
  • Works well for those that sleep on their back as the supine position is best for an optimal air seal. However, the added straps and support help keep the mask in place for restless sleepers.

Drawbacks of CPAP Full Face Masks:

  • Because of the larger surface area, there is a higher chance of air leakage.
  • Some users complain of air leakage near the top of the mask, causing dry, irritated eyes.
  • Most claustrophobic patients can’t tolerate the extra material and weight of the full face mask, although there are some exceptions.
  • Full face masks make it difficult to read or watch TV in bed or wear glasses.
  • If you’re a stomach sleeper, the bulk of the mask will make it difficult to sleep comfortably on your abdomen.

Things to consider during choosing a CPAP mask

  • Size, fit, and comfort are the most important considerations when choosing a CPAP mask. If the mask doesn’t fit, isn’t comfortable, or doesn’t meet your breathing needs, it’s not likely that you will be compliant with CPAP therapy. Take the time to go over the best mask for you with your vendor/technician, and don’t be afraid if you change your mind later and want to try a different mask.
  • Make sure to tell your vendor/technician if you are an active sleeper so that you get the most secure mask possible.
  • Tell your vendor/technician if you are claustrophobic or if there are areas of your face that are easily irritated.
  • If you have facial hair, it’s important to find a mask type that won’t leak due to the uneven surface area.
  • To watch TV, or wear glasses in bed, find a mask that allows you the best field of vision so as not to disrupt your nightly routine.
  • For mouth breather, you may need a full face mask or a nasal pillow/mask in conjunction with chinstraps.
  • As there are many different cushion types (gel, silicone, foam, cloth, etc), find which is most comfortable for you.

Starting a CPAP therapy for the first time

Many people have questions when they first start using CPAP. Talk with your sleep specialist about how to handle follow-up questions. He or she can answer some questions, but your home equipment provider may need to address others.

Ask your sleep specialist to recommend a home equipment provider that has a lot of experience with CPAP. Continue working with your sleep specialist as you adjust to CPAP.

We at My Home Health have been in business for over a decade now. In Kolkata, there are many sleep clinics but very few can claim to provide round-the-clock support like us. Our dedicated support team is here to help you anytime of day or night through telephone or email or physical support. We also have an easy payment plan & Rental options which means you don’t have to shell out a lot of money upfront for treatment.

Talk to us for any sorts of queries regarding a home CPAP therapy. 

Frequently Asked Questions on CPAP therapy

Does Sleep Apnea Cause Diabetes, or Vice Versa?

Sleep apnea and diabetes are related because it makes it more difficult for you to manage your diabetes. It tends to incite a state of severe insulin resistance. As a result, this can lead to compensatory hyper-insulinemia, and increase the requirement for higher doses of exogenous insulin. Prevalence of this condition can worsen or even lead to the development of type-2 diabetes in sleep apnea patients.

Can Sleep Apnea Cause Hypertension or Vice Versa?

Hypertension occurs in close correlation to Obstructive Sleep Apnea (OSA). Studies find that almost 50% of patients with hypertension also suffer from OSA. This correlation is greater in cases of people with resistant hypertension – people who have tried a variety of treatments to control their blood pressure but have been unsuccessful.

Can a Sleep Study be Done at Home?

Sleep apnea diagnosis can be done at home. This simplifies the testing procedure so don’t have to visit a hospital, but can rather take the test from the comfort of your home. You receive a pre-assembled test device at your doorstep that you can put on at night and sleep, while the test is carried out. The device measures breathing, airflow, heart rate and the level of oxygen in your blood. 

What are the Complications or Side Effects of CPAP?
  • Complications that may occur with CPAP therapy use include: 
  • Excessive dreaming, especially during the first days of treatment
  • Dry nose and sore throat 
  • Congested or runny nose, and sneezing 
  • Eyes and facial skin irritation 
  •  Abdominal bloating 

Other problems with CPAP machines that have been reported by patients include anxious and claustrophobic feelings, nosebleeds, and difficulty falling asleep. 

Most importantly, these complications don’t lasts forever and patient gets accustomed with all these within couple of days. Always talk to your doctor and take his help to ease the therapy.  

How soon will you feel the effects of CPAP therapy?

As per our experience of providing services to a good number of patients, most patients feel CPAP therapy’s effects as soon as they start the treatment. However, things are not always so simple for everybody. For some, the effects are cumulative, meaning that improvements only come with regular use of the machine for several weeks or even months.

Will I need to use my CPAP equipment for the rest of my life?

This is like using your reading glasses. Most people continue to sleep using their CPAP devices for the duration of their lives, even though their pressure setting may need to be adjusted downward due to improvements in the severity of their sleep apnea. However, some patients no longer need treatment because they lose weight; experience changes in their muscle tone; undergo oral surgery; or have their airway structures “trimmed” down by a physician. One should not stop using the machine without a doctor’s consultation.

I’ve been diagnosed with obstructive sleep apnea (OSA) I don’t have trouble sleeping; in fact, I can sleep anywhere, anytime! Why do I need CPAP treatment?

Having OSA doesn’t mean you have trouble falling asleep. Having OSA means you have trouble breathing while you are asleep.

Can I take my CPAP off after a couple of hours of use? Or should I use it throughout the whole night?

Ideally, we recommend that you wear your device whenever you sleep, your airway can become obstructed anytime you relax enough to fall asleep, such as after meals or watching TV.

If I go out of town for 1-2 days or less than a week, is it ok to leave my CPAP at home?

No. Every time you sleep your airway is obstructed and your oxygen drops your heart, brain, lungs, and other bodily systems are strained. That’s why it’s vitally important that you use continue your therapy whenever – and wherever – you sleep.

How often should I re-titrate my CPAP machine ? In other words, how often should I have another sleep study to determine if my equipment pressures are set appropriately for me?

The American Academy of Sleep Medicine (AASM) recommends that patients be “re-titrated” once a year or when lifestyle changes occur, to ensure that optimum therapeutic levels are maintained. This is especially important if you – Especially if/when you lose or gain weight; no longer feel you are getting optimal sleep; and/or if you are taking new medications (which can make apnea worse). Talk to your service provider for any assistance.

Should I buy CPAP with humidifier? What does the term, “humidification” mean in reference to CPAP therapy?

A: Humidification, refers to the process of adding humidity, or moisture, to the CPAP air, which reduces nasal passage irritation – and sometimes, bleeding – due to dryness. Additionally, adding moisture also reduces possible swelling, excess mucous, congestion, and sneezing, and makes patients’ sinuses less susceptible to bacterial infections. Humidification is therefore, a critical part of CPAP therapy. Ideally, you should buy a CPAP with a provision of adding a humidifier later, if needed. Talk to us for any sorts of clarification.

What type of power does my CPAP need?

Most CPAP and Bi-level (BiPAP) machines today are designed to operate on both AC and DC battery currents. The AC current from wall outlets is around 220 volts and most batteries produce 12 volts of DC current. 

What maintenance is required on machines?
  • The only care you are required to do for machines is to clean or change the filters at the air intake of the machine to keep the internal parts from accumulating dust. Here are some more tips on caring for your machine:
  • Keep the area around your machine clean and be sure to remove all dust. This will ensure that you continue to receive optimum air quality.
  • Keep the air intake of the machine unblocked. Curtains, bedding, and papers can easily block the air intake and reduce the airflow to your machine.
  • With most machines, it is easy to spill water from the humidifier into the machine and cause damage. Therefore, if you have a humidifier, avoid picking up your machine when the humidifier is attached. Instead, empty the water from the chamber every morning.
  • We highly recommend that you take your machine to the service station every 12 months at least to have it re-calibrated and cleaned by one of our certified CPAP clinicians.
How often should I clean the humidifier?

Daily: pour out last night’s water, rinse and air-dry. 

Weekly: Disinfect with 1 part white vinegar, 2 parts water (approximately 1/3 cup of white vinegar to 2/3 cup water); shake until the entire inside surface is coated and let it sit 15-20 minutes. Rinse clear and smell to be sure all vinegar is gone.

Should I use special water in my humidifier?

You should always use distilled water in your humidifier to prevent the build-up of mineral deposits on your water chamber. This will significantly prolong its life. Otherwise, normal filtered water also can be used.

How often should I change my CPAP filters?

At a minimum you should change your filters once in every three months. Do it more frequently, if your ambient air quality is poor. You should definitely change your filters, however, if you notice any discolouring. Additionally, you should wash and dry your filters as and when needed or weekly. 

I feel like my therapy may not be working because my machine is making loud noises and there’s a lot of air blowing from my mask? What should I do?

Either your mask is fitted incorrectly or your seal is wearing out, and needs to be replaced. Bring the machine to our service station for overall health check-up. You may consider to change your mask as well.

What kind of mask do I need?

Using the right mask is essential to the success of your treatment. You will need a mask this is comfortable and fits properly. It should form a good seal on your face so that air doesn’t leak (this would be uncomfortable and make your therapy less effective). A nasal mask which covers the nose is the most common. However, some people breathe through their mouth when they sleep. In this case, a full face mask that covers both the nose and mouth is the best option. Another option would be a nasal mask and chinstrap. This will prevent the jaw from opening during sleep and still provide for effective therapy.

My mask seems to be leaking. What does that mean?

Unfortunately, our faces are designed differently, and no mask will seal 100% of the time, because air will look to escape via every nook and cranny. However, you’ll want to get the best fitting mask and adjust your headgear properly to have the best seal. Also, before using your equipment make sure your face is clean and free from moisturizers, make up, or creams.

I often wake up with water in my mask/tubing – what can I do? Why does this happen?

Your humidifier is on too high. Start at the 1st setting and gradually increase as necessary each night.

I am experiencing a cut on the bridge of the nose. What should I do?

If so, your mask is probably too tight so we suggest that you loosen it a bit. Also, put some zinc oxide, a band-aid, or skin tape on the affected area, but do not discontinue your CPAP therapy.  However, if your sore continues to worsen, contact your physician. You may need to return to your CPAP clinic for another mask- one with a more comfortable, and better-fitting style.