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CPAP

Continuous positive airway pressure (CPAP) is the frontline treatment for obstructive sleep apnea. CPAP keeps your airway open during the night by gently providing a constant stream of air through a mask you wear while you sleep. This will eliminate the breathing pauses caused by sleep apnea, so you will no longer snore or make choking noises in your sleep. You will be able to sleep through the night without your body waking up from lack of oxygen.
When you use CPAP, you will feel more alert during the daytime. Your mood will improve and you will have a better memory. CPAP prevents or even reverses serious health problems associated with sleep apnea such as heart disease and stroke. Your partner may even sleep better because you will stop snoring.
CPAP comes with a machine, a hose for air and a mask. Most machines are small – about the size of a tissue box – lightweight and relatively quiet. You can keep the CPAP machine on your nightstand or at the side of your bed.
A long hose connects the CPAP machine to the mask. Air travels from the machine’s motor, through the hose and into the mask. Most hoses are long so that you can move around or turn over in your bed.
The CPAP mask may cover just your nose, your nose and mouth or fit in your nostrils. No matter what type of mask you use, it is important that it fits well and is comfortable. The mask must make a seal in order to keep your airway open through the night. A good mask seal will prevent air leaks and maintain the right level of air pressure.
The amount of air pressure need for CPAP to treat sleep apnea depends on the person. A board certified sleep medicine physician may recommend a CPAP titration study to calibrate your CPAP. Most CPAP units also come with a timed pressure “ramp” setting. This starts the airflow at a very low level, so you can fall asleep comfortably. The setting then slowly raises the pressure while you sleep until it reaches the right level to treat your sleep apnea.
CPAP is a lifestyle change. It works best when used every night, for the whole time you are sleeping. You should also use CPAP when you are napping. Just one night without the treatment can negatively affect your blood pressure. The more you use CPAP, the better you will feel.

CPAP – Benefits
Health Risk Prevention
CPAP can prevent or reverse serious consequences of obstructive sleep apnea. The treatment can help protect you from these serious health risks:

Heart Disease
By treating your sleep apnea, you can reduce your risk of heart disease. Sleep apnea is linked to a variety of heart problems because it causes you to stop breathing many times each night. These pauses cause changes in the pressure on your heart and can cause changes in your blood oxygen levels. This puts an enormous strain on your heart.
People with untreated sleep apnea have a higher rate of death from heart disease than those without sleep apnea or with treated sleep apnea. Using CPAP over an extended period of time can protect you from heart problems and reduce your chance of dying from them. This includes:
• Congestive heart failure
• Coronary artery disease
• Irregular heartbeat

Stroke
If you have sleep apnea, consistent CPAP use can reduce your risk of stroke, one of the leading causes of death and long-term disability. A stroke is a sudden loss in brain function. It occurs when there is a blockage or rupture in one of the blood vessels leading to the brain. People with untreated sleep apnea are two to four times more likely to have a stroke.
Diabetes
Using CPAP to treat your sleep apnea can improve insulin sensitivity. Sleep apnea is related to glucose intolerance and insulin resistance, both factors in type 2 diabetes. Untreated sleep apnea increases your risk of getting type 2 diabetes.
Motor Vehicle Accidents
CPAP can help you become a safer driver by reducing your daytime fatigue. Untreated sleep apnea makes you 15 times more likely to be involved in a deadline crash. Many people with sleep apnea have a hard time staying awake and concentrating while driving.
Benefits to Your Health and Well-Being
Using CPAP to treat your sleep apnea can improve your life and make each day better. It can help improve your:

Daytime Alertness
Sleepiness and daytime fatigue are common symptoms of sleep apnea. CPAP can restore your normal sleep pattern and increase your total sleep time by eliminating breathing pauses in your sleep. This will help you wake up feeling more refreshed and boost your energy throughout the day.

Concentration
Untreated sleep apnea can make you feel cloudy-headed because it interferes with your cognitive functioning. Using CPAP may improve your ability to think, concentrate and make decisions. This can also improve your productivity and decrease your chance of making a costly mistake at work.

Emotional Stability
Untreated sleep apnea is linked with depression. CPAP can help improve your mood, reduce your risk of depression and improve your overall quality of life.

Snoring
By keeping your airway open as you sleep, CPAP can also reduce or eliminate the sound of your snoring. While you may not notice, you bed partner will benefit from a quieter sleep environment.

Medical Expenses
People with untreated sleep apnea usually have higher medical expenses. Treatment with CPAP can reduce medical expenses, even when you factor in the cost of CPAP. Sleep apnea can lead to more health problems and more doctors’ visits. Treatment for serious health risks linked to sleep apnea such as heart disease, stroke and diabetes can be costly. Medical expenses will decrease when you use CPAP to treat your sleep apnea.

CPAP – Side Effects
CPAP has relatively few side effects. Most of the problems people experience happen after they first begin the treatment, and are easily fixed through simple adjustments:

Irritation of the eyes and face
This is often due to a poor mask fit. By readjusting or switching the type of mask that you use, you can eliminate these symptoms.

Dry nose and sore throat
A humidifier attached to your CPAP unit reduces dry nose and sore throat by providing cool or heated moisture to the air that blows down your throat.
Nasal congestion, runny nose and sneezing
Use a saline nasal spray to ease mild nasal congestion. A nasal decongestant can help will more severe nasal or sinus congestion. In severe cases, prescription medications can be used to help adjust to CPAP.
Nightmares and excessive dreaming
This typically occurs only during the early stages of CPAP use.

Most other side effects are relatively rare.
CPAP – Variations
Types of PAP therapy
There are several forms of PAP therapy other than CPAP. All forms of PAP therapy keep the airway open during the night by providing a stream of air:
APAP
Automatically-adjusting Positive Airway Pressure (APAP) therapy automatically raises or lowers the air pressure as needed during the night.
BPAP
BPAP devices have two alternating levels of pressure. When you breathe in air the pressure rises. The pressure decreases as you breathe out. If you have a problem with CPAP or APAP, the board-certified sleep medicine physician may recommend BPAP. He or she may also suggest BPAP if you have sleep apnea along with another breathing disorder.

Types of Masks
There are three common types of masks for CPAP. No matter what type of mask you use, it is important that it fits well and is comfortable.
Nasal mask
This mask only covers your nose. This is the most common type of CPAP mask.
Full face mask
This mask covers both your nose and your mouth. This type of mask may help if you have air leaks when using a nasal mask.
Nasal pillows
This mask uses soft silicone tubes that fit directly in your nose. This may help if you have air leaks or don’t like the feeling of a mask over your nose and face. Some users claim nasal pillows give them a better sense of freedom.

Humidifiers
Humidifiers for CPAP can help reduce side effects associated with the treatment and make it easier for you to breathing through your mask. Some people may have nasal irritation or drainage from using CPAP. A humidifier can reduce these side effects by providing cool or heated moisture to the air coming from the CPAP unit. Many modern CPAP units come with a humidifier connected with the machine.

Tips for CPAP
It may take some time for you to become comfortable with using CPAP. Follow these tips to improve your quality of sleep with CPAP:
Begin using your CPAP for short periods of time during the day while you watch TV or read
This will help you get used to wearing your mask. It will feel more natural when you are trying to fall asleep.
Make CPAP part of your bedtime routine.
Use CPAP every night and for every nap. Using CPAP less often reduces its health benefits and makes it more difficult for your body to adjust to the therapy.
Make small adjustments to increase your level of comfort
Adjust your mask, tubing straps and headgear until you get the fit right. You can also try using a special bed pillow that is shaped for a PAP mask and/or hose.
Make sure your mask is a good fit. The most common problems with CPAP occur when the mask does not fit properly.
If the mask is too big, the straps holding it to your face will need to be pulled tightly. This may irritate your skin or lead to sores as the straps rub against your face. A mask that is too small will not seal properly and air will leak out through the edges. The air may blow into your eyes. If you are having either problem, you may need a different mask or headgear.
If the pressure feels too high as you are trying to fall asleep, use the “ramp” mode on your CPAP unit
Ramp mode will start your device on a low pressure setting and gradually increases the pressure over time. You should be able to fall asleep before the air pressure reaches its proper level.
Use a saline nasal spray to ease mild nasal congestion
Nasal congestion can be a problem with CPAP treatment. A nasal spray or decongestant can help with nasal or sinus congestion.
Use a humidifier if you have a dry mouth, throat or nose
Some CPAP devices have heated humidifiers, which are chambers filled with water on a heater-plate. This feature ensures that you are breathing warm, moist air through your mask. If you are using a heated humidifier and the tubing fills with water, turn down the heat on the humidifier and keep the PAP machine at a level lower than your head.
Place foam under your CPAP machine to dampen the sound
This may help if you find the sound of the CPAP machine to be annoying. A mouse pad also works great as a noise dampener.
Schedule a regular time to clean your equipment
Clean your mask, tubing and headgear once a week. Put this time in your schedule so that you don’t forget to do it.
If you are having problems remembering to use your CPAP every night, find someone to help
Considering joining a support group or asking someone you trust to hold you accountable for using your CPAP.
If these adjustments do not work, consult your board-certified sleep medicine physician.
You may need a different mask or device or you may need the air pressure adjusted. Some patients may also benefit from cognitive-behavioral therapy. This can help you identify and overcome what is preventing you from getting a good night’s sleep with CPAP.
If you think you may have sleep apnea or need CPAP, find a board certified sleep medicine physician at an American Academy of Sleep Medicine Accredited Sleep Center near you.