CPAP therapy for Obstructive Sleep Apnoea (OSA)

 
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CPAP

CPAP (Continuous positive airway pressure) therapy for Obstructive Sleep Apnoea (OSA)

Continuous positive airway pressure therapy (CPAP) uses a machine to help a person who has obstructive sleep apnoea (OSA) breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway does not collapse when you breathe in. When you use CPAP, your bed partner may sleep better, too.

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You use CPAP at home every night while you sleep. The CPAP machine will have one of the following:

• A fullface mask that covers your nose and mouth.
• A nasal mask that covers your nose only-called nasal continuous positive airway pressure, or NCPAP (this type of mask is most common).
• A pillow mask that fits into your nose.

 

If you have been diagnosed with obstructive sleep apnoea (OSA), a condition in which relaxation of the muscles around the tongue and throat causes the tissues to block airflow to the lungs while you sleep, CPAP therapy is the recommended form of treatment for those individuals who suffer from sleep apnoea.

Benefits of CPAP include keeping your airways open while you sleep, easing snoring, improving sleep quality, relieving daytime sleepiness, and lowering blood pressure.

Although you will likely feel better rested and alert once you start CPAP, getting used to the device can take some time. Some people have difficulty sleeping the first few nights of treatment.

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You may want to try an Auto CPAP machines that have automatically adjustable air pressure or air pressures that are different when you breathe in than when you breathe out.

What To Expect After Treatment


It may take time for you to become comfortable with using CPAP. If you cannot get used to it, talk to your doctor. You might be able to try another type of mask or make other adjustments.

Why It Is Done

CPAP is the most effective nonsurgical treatment for obstructive sleep apnea. It is the first treatment choice and the most widely used.

• Doctors use CPAP to treat people who have moderate to severe sleep apnoea.
• CPAP is the treatment of choice for people who have sleep apnoea and coronary artery disease (CAD) or heart failure.

How Well It Works

Overall, CPAP is the most effective treatment for moderate and severe obstructive sleep apnea:

• Research shows that continuous positive airway pressure (CPAP) decreases daytime sleepiness, especially in those with moderate to severe sleep apnea..
• Studies show that in people who have moderate to severe sleep apnea, nasal continuous positive airway pressure (NCPAP) lowers blood pressure during both the day and the night.
• CPAP is often more effective than other non-surgical methods for treating systemic obstructive sleep apnea.
• People with coronary artery disease who use CPAP for sleep apnea are less likely to have heart problems such as heart failure.
 
Problems that may occur with CPAP include:

• Dry nose and sore throat.
• Nasal congestion, runny nose, and sneezing.
• Irritation of the eyes and the skin on the face.
• Abdominal bloating.
• Leaks around the mask because it does not fit properly.

Nosebleeds are a rare complication of CPAP.

You can expect mild discomfort in the morning when you first start using CPAP. Talk with your doctor if you do not feel comfortable after a few days.

Relieving side effects

You may be able to limit or stop the side effects:
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• Your doctor may be able to adjust your CPAP to reduce or eliminate problems.
• Be sure the mask or nasal prongs fit you properly. Air should not leak around the mask.
• Use a humidifier or a corticosteroid nasal spray medicine to reduce nasal irritation and drainage.
• You may want to talk to your doctor about trying a CPAP machine that will start with a low air pressure and slowly increase the air pressure as you fall asleep. This kind of machine can help reduce discomfort caused by too much constant pressure in your nose. If this does not improve your discomfort, ask your doctor about trying a bilevel positive airway pressure machine (BiPAP), which uses a different air pressure when you breathe in than when you breathe out. BiPAP may work better than standard CPAP for treating obstructive sleep apnea in people who have heart failure. BiPAP machines are more expensive than CPAP machines.
• If your nose is runny or congested, talk with your doctor about using decongestants or corticosteroid nasal spray medicines or fullface masks.

What To Think About


When you are using CPAP, you need to see your doctor or sleep specialist regularly. You may also need more sleep studies to adjust the CPAP machine and check whether the treatment is working.

The most common problem with CPAP is that people do not use the machine every night. Or they take off the mask during the night because it becomes uncomfortable. Even one night of not using the machine can make you sleepy the next day.

You might not use the machine daily, or you might even stop using it because:

• You don't like wearing a mask because of nasal discomfort.
• The machine is noisy.
• It may discourage intimacy with your sleeping partner, even though you use the machine only while you are sleeping.

The best treatment for obstructive sleep apnea depends on a number of factors, including the severity of your problem, the physical structure of your upper airway, other medical problems you may have, as well as your personal preference. You should work with your doctor or sleep specialist to select the best treatment option for you.


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Snoring Treatments & Solutions

If you occasionally snore, you can try the following conservative behaviour changes to help treat the problem:

• Lose weight and improve your eating habits.
• Avoid tranquilizers, sleeping pills, and antihistamines before you go to bed.
• Avoid alcohol, heavy meals, or snacks at least four hours before you sleep.
• Establish regular sleeping patterns. For example, try to go to bed at the same time every night.
• Sleep on your side rather than on your back.
• Prop the head of your bed -- not just your pillows -- up four inches.

If none of the above mentioned behavioural changes help snoring, talk to your doctor. Otolaryngologists (ear, nose, and throat doctors) offer a variety of treatment options that may reduce or eliminate snoring or sleep apnea.
There are more than 300 devices on the market to help prevent snoring; however, none of these devices address all of the underlying anatomical problems that cause snoring (such as nasal obstruction and being overweight). Surgery may be one option needed to correct physical problems.

Snoring and Sleep Apnoea Surgeries

Uvulopalatopharyngoplasty (UPPP or UP3): A surgical treatment that tightens and restructures the flabby tissues in the throat and palate. This is often prescribed for people who have moderate or severe obstructive sleep apnea.

Laser-assisted uvula palatoplasty (LAUP): A laser procedure removes the airway obstruction. This treatment is performed under local anaesthesia in a doctor's office and is intended for snorers and for people with mild obstructive sleep apnea.

Somnoplasty: This is a minimally invasive procedure that uses radio frequency energy to shrink excessive tissue in the palate, uvula, and tongue tissue. This treatment can also be used to relieve nasal obstruction.

Genioglossus and hyoid advancement: This is a surgical treatment for sleep apnea which prevents the collapse of the lower throat by pulling the tongue forward.

Septoplasty and turbinate surgery: This is a surgery to fix blockages in the nose and help air through the nose smoothly and quietly.

Tonsillectomy: Removing the tonsils and adenoids may be needed to prevent snoring, particularly in children.


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