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Sleep apnoea treatments
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CPAP for sleep apnoea
What is CPAP?
CPAP (Continuous Positive Airway Pressure) is a medical device designed to treat sleep breathing disorders, such as obstructive sleep apnea (OSA).
Its operation is based on providing a constant flow of pressurized air through a mask fitted to the patient's face, which keeps the airways open during sleep and prevents apnea episodes.
The use of a CPAP helps ensure adequate oxygenation during the night, allowing for more restful sleep and improving the patient's quality of life. By eliminating airway collapse, CPAP reduces associated problems such as snoring, frequent micro-awakenings and daytime sleepiness.
How does it work
The device consists of three main components:
- Air pressure unit: it is the motor that generates a continuous flow of air at a personalized pressure, adjusted according to the patient's needs.
- Mask: available in different types (nasal, facial or nose pads), fits comfortably on the face to direct the airflow towards the respiratory tract.
- Connecting tube: connects the pressure unit to the mask and ensures an efficient air supply.
The treatment of choice for OSA
The most common treatment for obstructive sleep apnoea is the use of a CPAP (continuous positive airway pressure) machine during the night. A compressor emits a flow of air that exerts positive pressure on the airways through a mask, thus preventing the upper airways from collapsing during sleep.
Benefits of CPAP
CPAP treatment is indicated for use during sleep every night. As it is not a curative treatment, it must be used continually, and stopping using it will cause symptoms to reappear. Nonetheless, using a CPAP machine provides the patient with a host of benefits:
- It corrects obstructive apnoeas, eliminates hypoapnoeas and should stop the patient from snoring.
- It prevents low blood oxygen and micro-arousals caused by respiratory events, as well as restoring normal sleep architecture.
- It relieves symptoms of OSA and improves the patient’s quality of life.
- In addition, treatment with a CPAP machine reduces the risk of traffic accidents in patients with OSA.
What is APAP and how is it different from CPAP?
APAP, AutoCPAP, or Auto-Adjusting Positive Airway Pressure, is a device similar to CPAP, but with advanced functionality that automatically adjusts air pressure during sleep.
While CPAP provides a constant level of pressure, AutoCPAP monitors the patient's breathing in real time and adapts the pressure as needed. This is especially useful because the pressure required can vary depending on sleeping position, sleep stages, or factors such as nasal congestion.
Main differences between APAP and CPAP
- Constant vs. variable pressure: CPAP offers a fixed pressure programmed by the doctor while APAP varies the pressure automatically according to the patient's demand.
- Adaptability: APAP is more flexible, making it suitable for people with variable sleep apnea or those who have difficulty adapting to constant pressure.
Continuous positive airway pressure (CPAP) machine
The components needed for CPAP treatment are a machine that exerts positive pressure on the upper airways, a mask and a hose that connects the machine to the mask. The following instructions should be followed:
- Place the CPAP machine on a bedside table, near the headboard, so that it cannot fall over during sleep. Make sure to not place the machine somewhere where someone might bump into it or trip on its power cable.
- Ensure the area around the machine is clean and dry. The CPAP machine should be positioned so that nothing is obstructing the air inlet at the back.
- Connect the power cable to the socket at the back of the CPAP machine then plug it into the mains.
- One end of the hose must be connected to the machine outlet and the other, to the mask.
Another important element to remember is the ramp function. The ramp function gradually increases the pressure over a certain time period (up to 45 minutes) while falling asleep, until reaching the prescribed pressure. Using a humidifier is an option to be considered in order to humidify the air being breathed in. To use a humidifier, attach it to the CPAP machine and fill its tank with distilled water up to the corresponding line.
CPAP machine maintenance
The technical team of OXIGEN salud will carry out regular checks on the equipment. However, it is important to follow the recommended hygiene and cleaning guidelines, as they will make the treatment more comfortable and ensure the CPAP machine lasts as long as possible:
- Before going to bed, wash your face. This will remove any excess oil before you put the mask on.
- Wash the mask daily with water and mild soap. Rinse it thoroughly and leave it to dry. Store it in a clean, dry place.
- The headgear can be washed with laundry in the washing machine.
- The hose should be washed with warm water and mild soap. Rinse it thoroughly then hang it up to dry (not outside, as the plastic might get damaged). Store it in a clean, dry place.
- Remove the air filter from the back of the CPAP machine and wash it regularly.
- Unplug the machine and clean it regularly with a slightly damp cloth. Do not submerge the CPAP machine or its power cable in water. Always unplug the machine before cleaning it.
Using and positioning the mask
There is no need to alter the headgear on the mask provided by OXIGEN salud every time you use it, as the assistance team will fit it to your head when they install the machine. However, here are some basic guidelines for adjusting the mask properly for daily use:
- Adjust the mask, in accordance with the model, so that the forehead support is fully extended.
- Unfasten the bottom clip on the headgear, hold the mask over your nose and pull the headgear over your head. Make sure the straps are not twisted.
- Fasten the bottom clip again and make sure it is secure.
- Adjust the upper straps so that they are even. Make sure they are not too tight. Adjust the lower straps until they are comfortable.
- Connect one end of the hose to the swivel piece and the other end to the machine.
- Turn the machine on and breathe normally. Lie down and adjust the hose so that you can move freely if you turn over while you sleep.
- Adjust the forehead support to correct any leaks at the nose. Adjust the lower straps to correct any leaks at the lower lip. It is normal for there to be a certain level of leak so that you can exhale.
- If you need to get up during the night, disconnect the hose from the mask and turn off the machine. When you get back into bed, connect the hose to the mask again and turn the machine back on.
Side effects of the CPAP machine and how to prevent them
Side effects are common during the first weeks of using the CPAP machine.
In general, they tend to be mild and temporary and can be alleviated with a few simple measures:
- Nasal congestion or obstruction is the most common side effect, and it usually goes away on its own.
- Skin irritation in the area in contact with the CPAP mask also usually goes away on its own over time. You can apply moisturiser to the contact area every morning to keep the skin hydrated. For sensitive skin, protectors can be used.
- A dry throat usually gets better on its own. If it carries on for more than four weeks, contact your doctor so that they can prescribe a humidifier to attach to the CPAP machine.
- Noise is usually not an issue that requires any adaptation from the patient or their partner or roommate. Modern CPAP machines are very quiet and the masks used today should not make any bothersome noise if they are adjusted properly.
- Conjunctivitis may occur as a result of an air leak through the mask. It will disappear when the mask is adjusted properly.
- Nose bleeds may occur due to dryness in the nose. You can make sure the lining of the nose does not dry out by attaching a humidifier to the CPAP machine and avoiding the use of heaters that dry out the air. If it carries on for more than four weeks, contact your doctor so that they can prescribe a humidifier to attach to the CPAP machine.
- Headaches are uncommon, but they should go away with time.
- The cold can be an issue, especially in cold regions and homes without heating. The solution is to increase the temperature in the room or put the hose inside the bedsheets.
- Insomnia may occur for some patients as they adapt to the treatment. The CPAP treatment can be introduced gradually as you adapt. You do not need to use it all night as soon as you begin the treatment.
- Aerophagia, meteorism and digestion issues (through swallowing air from the CPAP machine) are uncommon symptoms, but they should improve as you adapt and become less anxious.
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