A CPAP machine, or Continuous Positive Airway Pressure, is a device used to manage obstructive sleep apnea (OSA). This condition causes breathing interruptions during sleep due to soft tissue collapse in the throat. CPAP therapy is an effective treatment for OSA, helping individuals maintain open airways throughout the night, stabilizing breathing and improving sleep quality.
How CPAP Therapy Works
During an obstructive sleep apnea event, throat muscles relax, causing tissues to collapse and block the airway. A CPAP machine counters this by drawing in room air, filtering it, and then pressurizing it. This constant, gentle stream of pressurized air delivers through a flexible tube connected to a mask worn over the nose, or both the nose and mouth. The continuous airflow acts like a “pneumatic splint,” maintaining an open upper airway during both inhalation and exhalation. This prevents the throat from collapsing, ensuring consistent breathing and adequate oxygen intake.
Different Types of PAP Machines
Other positive airway pressure (PAP) machines offer varied pressure delivery methods. A standard CPAP machine delivers a single, constant air pressure setting throughout the night. This fixed pressure level is determined during an overnight sleep study to keep the airway open.
An Automatic Positive Airway Pressure (APAP) machine automatically adjusts air pressure throughout the night. These devices use algorithms to monitor breathing patterns in real-time, increasing or decreasing pressure as needed based on sleep position or respiratory events. This dynamic adjustment can provide greater comfort and adaptability.
Bilevel Positive Airway Pressure (BiPAP) machines feature two distinct pressure settings: a higher pressure for inhalation and a lower pressure for exhalation. This dual-pressure system can be beneficial for users who find it challenging to exhale against the constant pressure of a standard CPAP machine. BiPAP is often prescribed for individuals with complex sleep disorders or those requiring higher pressure settings.
Adjusting to Your CPAP Machine
Beginning CPAP therapy can present challenges, but several strategies can help ease the adjustment process. Mask discomfort or air leaks are common concerns, often stemming from an ill-fitting mask. Trying different mask styles, such as nasal pillows, nasal masks, or full-face masks, can improve comfort and seal. Ensuring the straps are snug but not overly tight also helps prevent leaks and irritation.
Another frequent issue is dry mouth or nose, which can occur due to the continuous airflow. Most modern CPAP machines include a heated humidifier, or one can be added, to introduce warm water vapor into the air, counteracting dryness. Using distilled water is recommended to maintain the device. For those who breathe through their mouth, a chin strap or a full-face mask can help keep the mouth closed, reducing air leakage and associated dryness.
Feelings of claustrophobia are also reported by some new users. To acclimate, it is suggested to wear the mask for short periods while awake, such as watching television. Gradually increasing the wear time, even without the machine on, can help build comfort. Many machines also feature a “ramp” function, which starts at a lower, more comfortable pressure and gradually increases to the prescribed setting over a set period.
CPAP Alternatives
Several alternative treatments for sleep apnea exist for individuals who find CPAP therapy difficult to tolerate. Oral appliances, such as mandibular advancement devices, are custom-fitted mouthguards worn during sleep. These devices reposition the jaw forward or hold the tongue in place, keeping the upper airway open. Oral appliances are considered for mild to moderate obstructive sleep apnea.
Surgical options address anatomical obstructions. Procedures like uvulopalatopharyngoplasty remove or reposition excess throat tissue. Maxillomandibular advancement surgery moves the jawbones forward to enlarge the airway. Hypoglossal nerve stimulation is another option, where an implanted device stimulates the nerve controlling tongue movement to prevent airway collapse.
Lifestyle modifications also manage sleep apnea, particularly for less severe cases. Weight loss can reduce symptoms for individuals who are overweight or obese, as excess neck tissue contributes to airway collapse. Positional therapy encourages sleeping on one’s side, as sleeping on the back can worsen apnea events. Avoiding alcohol and sedatives before bed can help, as these substances relax throat muscles, increasing airway obstruction.