Treatment options for OSA patients requiring treatment, but who are unable or unwilling to tolerate CPAP therapy, include weight loss, oral appliances, and upper airway surgeries. Alternative approaches that have come to the market more recently, including nasal expiratory resistance and oral negative pressure devices, will also be discussed.
Full Answer
What should I do if my patient is uncomfortable with CPAP?
Your patient should be confident in your abilities. When a patient is uncomfortable with CPAP it’s your job to come up with a solution. Asking your patient “What do you want to do?” is like a parent asking their newborn “What do you want to eat today?”
Is your CPAP treatment frustrating?
CPAP is an important treatment for obstructive sleep apnea, but it may be frustrating at first. Learn how to avoid uncomfortable masks and other common CPAP problems.
What happens if you don’t clean your CPAP machine?
In short, a lack of regular cleaning of your CPAP can lead to two main problems – health problems as a result of bacteria and issues with the machine not functioning to the best of its ability. In some cases, you may even void the warranty of the machine and cause it to fail way before it should do.
Who is the woman who refuses to use a CPAP machine?
Her husband told her she snored. But Faulkenburg, 47, couldn’t tolerate the CPAP machine her doctor prescribed. “I just could not get used to the face mask covering both my nose and mouth,” said Faulkenburg, who lives in Oviedo, Fla.
What happens if you refuse CPAP?
Many people worry that not using CPAP for one night may put their health at risk. The risk of sudden death, stroke, or heart arrhythmia due to sleep apnea that occurs during one night of failed use is likely vanishingly small. Instead, sleep apnea is a long-term risk factor for these medical consequences.
What is an alternative to CPAP?
If CPAP isn't for you, a few other OSA treatment options include: an oral appliance. bilevel positive airway pressure (BiPAP) nasal valve therapy.
Can you quit CPAP?
As long as you have sleep apnea, you will continue to need to use CPAP therapy. That being said, you can discontinue the use of your CPAP machine if your sleep apnea becomes cured or enters remission.
What happens if you have sleep apnea but don't use CPAP?
But the health effects of untreated sleep apnea can be serious. People struggle with anxiety, tiredness and low productivity. There's even an increased risk of high blood pressure, heart attack and stroke.
How can I sleep without CPAP?
5 Sleep Apnea Treatment OptionsOral Appliances. Just as there are dental professionals who specialize in orthodontics or dental implants, there are also those who can help with sleep apnea. ... Oral Surgery. In some cases, genetics can be the cause of sleep apnea. ... Weight Loss. ... Positional Therapy. ... Inspire Therapy.
What is the newest treatment for sleep apnea?
The new treatment - known as Inspire Upper Airway Stimulation (UAS) therapy - offers the first implantable device for treating obstructive sleep apnea. The therapy works from inside the body and with the patient's natural breathing process.
Can your body become dependent on a CPAP machine?
CONCLUSIONS: Patients with the sleep apnoea/hypopnoea syndrome regularly using CPAP for more than four hours per night all showed an increase in dPAS supine. The use of chronic CPAP increases PAS supine probably by a reduction in upper airway oedema, and the change in size is dependent on CPAP use.
Does sleep apnea reduce life expectancy?
Risks of obstructive sleep apnea Sleep apnea is dangerous because if untreated, it leads to high blood pressure and is associated with an increased chance of heart attack, abnormal heart rhythms and heart failure. Studies have shown that sleep apnea can decrease life expectancy by several years.
What is considered severe sleep apnea?
Obstructive sleep apnea is classified by severity: Severe obstructive sleep apnea means that your AHI is greater than 30 (more than 30 episodes per hour) Moderate obstructive sleep apnea means that your AHI is between 15 and 30. Mild obstructive sleep apnea means that your AHI is between 5 and 15.
Why is CPAP not tolerated?
Sometimes CPAP is not tolerated because sleep is poor, or fragmented due to other issues such as anxiety, PTSD, insomnia, poor sleep habits, or circadian disorders. These other problems need to be addressed. Consider alternative treatments. CPAP is the first-line treatment, but not the only treatment for OSA.
What is a CPAP?
CPAP is recommended by the American Academy of Sleep Medicine (AASM) as the initial treatment for moderate or severe OSA, and in mild cases of OSA when associated with insomnia, disrupted sleep, or excessive daytime sleepiness. When used consistently, and when treatment is effective, CPAP improves daytime sleepiness, quality of life, ...
What is a CPAP mask?
Continuous positive airway pressure, or CPAP, is the most common treatment prescribed for obstructive sleep apnea (OSA). CPAP involves wearing a mask that fits into the nostrils, underneath or over the nose, or over the nose and mouth , through which pressurized air is delivered via tubing from a machine to keep the upper airway open during sleep. CPAP is recommended by the American Academy of Sleep Medicine (AASM) as the initial treatment for moderate or severe OSA, and in mild cases of OSA when associated with insomnia, disrupted sleep, or excessive daytime sleepiness. When used consistently, and when treatment is effective, CPAP improves daytime sleepiness, quality of life, and it can have positive impacts on cardiac and metabolic health.
Why does my CPAP make my mouth dry?
Mouth breathing is another mask-related factor to consider. When a patient sleeps with their mouth open, the pressure from the CPAP leaks out the mouth. This causes dryness, and also prevents CPAP from keeping the upper airway open. Mask leak can also result in noise and mask removals during sleep.
How many people do not reach minimum adherence criteria for CPAP?
Despite the many potential benefits, CPAP adherence estimates from clinical data and insurance groups suggest that about 50% of CPAP users either do not reach minimum adherence criteria or discontinue the treatment. Each patient is unique and may have individual struggles with CPAP; however, there tend to be similar themes among users. Some of the common complaints I hear from patients who have trouble tolerating CPAP include
What are the issues with wearing a mask?
mask issues, including mask discomfort , skin irritation or marks , feelings of claustrophobia, or discomfort with the appearance of wearing a mask. dryness, especially waking with a dry mouth. removing the mask during sleep.
Does CPAP help with sleepiness?
When used consistently, and when treatment is effective, CPAP improves daytime sleepiness, quality of life, and it can have positive impacts on cardiac and metabolic health. The effectiveness of CPAP depends on using the device correctly and consistently, since OSA is a chronic disease that requires long-term treatment.
Oral Appliances
Information source: Harold A. Smith, DDS, president of the American Academy of Dental Sleep Medicine (AADSM)
Night Shift
Information source: Daniel J. Levendowski, president, Advanced Brain Monitoring
Provent Sleep Apnea Therapy
Information source: John Guinipero, national sales manager, Provent Sleep Therapy LLC
Winx
How it works: Winx delivers a light vacuum through a soft flexible mouthpiece, which helps keep the airway open during sleep by keeping the tongue and soft palate from falling back and blocking the airway.
Pillar Procedure
Information source: Craig Schwimmer, MD, MPH, FACS, chief medical officer, Pillar Palatal LLC
Somnoplasty
How it works: Somnoplasty, also known as temperature-controlled radiofrequency (TCRF), is a minimally invasive surgical technology that uses radiofrequency current to reduce tissue volume in a precise, targeted manner. (Somnoplasty device by Olympus pictured.)
Bariatric Surgery
Information source: Information provided in 2014 by John Morton, MD, MPH, FACS, FASMBS, chief, Bariatric and Minimally Invasive Surgery, Stanford School of Medicine (At deadline in 2017, Morton was on paternity leave and the American Society for Metabolic and Bariatric Surgery did not respond to an emailed request for a spokesperson.)
Why do patients want to stop CPAP?
This scenario happens often. Some patients want to stop therapy because they feel unable to tolerate it.
Why does my CPAP mask feel so tight?
The CPAP mask may feel too large, small, or tight which can leave red marks on the face or give a feeling of claustrophobia. The CPAP air may be blowing too hard or it may be leaking out of the mask. Whatever the issue, there are lots of people who just can’t find comfort using CPAP equipment and therefore discontinue use.
How does a CPAP humidifier work?
The increasing temperature of the heater plate heats the water in the chamber and adds moisture to air flowing through .
Why humidify a CPAP?
The nasal irritation also creates a very fertile ground for infections. Using humidification will add moisture to the CPAP air, therefore CPAP humidification is a critical part of CPAP Therapy.
What is the comfort feature of a CPAP machine?
Available on most CPAP machines is a comfort feature called expiratory pressure relief. Depending on which brand of machine you have, it may be called CFLEX, AFLEX OR BIFLEX.
What does it mean when you have a bloated stomach with a CPAP?
It’s the medical term for the phenomenon when air enters the esophagus, goes into the belly and causes bloating.
Can CPAP cause stomach bloating?
Aerophagia and stomach bloating is more common than you might think and it’s a subject that most don’t feel comfortable talking about. But this side effect of CPAP use is important to discuss because with a few changes to CPAP therapy, it can be resolved.
What are the problems with CPAP machines?
People struggle with anxiety, tiredness and low productivity. There’s even an increased risk of high blood pressure, heart attack and stroke. Mary Mertens, a respiratory therapist at the Cleveland Clinic, helps patients work through problems with their CPAP machine.
How many people stop using CPAP?
The big whoosh of air in your throat. The restrictive mask on your face. It can be a lot to adjust to. Studies suggest that from one-third to more than 50% of patients either stop using their CPAP machine or never bother to fill their prescription.
Why does a CPAP machine make you sleepy?
A CPAP machine blows a stream of air into the back of the throat to let people breathe easier. It prevents muscles in the back of the throat from narrowing, which can constrict the airway, causing snoring or disturbed sleep. Yet Faulkenburg quit using her CPAP and went back to feeling sleepy and tired all the time.
Why do people quit sleeping pills?
Sometimes, they quit because of confusing or stringent health insurance restrictions. But the health effects of untreated sleep apnea can be serious. People struggle with anxiety, tiredness and low productivity.
Can CPAP cause a runny nose?
Pulmonologist James Rowley, a sleep medicine physician at Detroit Medical Center, said the air pressure from the CPAP can cause a runny nose, nasal congestion or dry mouth. He said he can help by adjusting humidity settings on the machine or prescribing an antihistamine.
Does CPAP help with sleep apnea?
CPAP, or continuous positive airway pressure, is often one of the first solutions doctors suggest for sleep apnea. With this disorder, a person’s breathing stops and starts so frequently during the night that it can lead to or exacerbate health problems. The National Sleep Foundation estimates that more than 18 million American adults have sleep ...
Did Frances Faulkenburg have sleep apnea?
When doctors told Frances Faulkenburg she had sleep apnea, she was more than ready for relief from her tired-all-the-time existence. She used to fall asleep at red lights while behind the wheel. At night, she’d wake up gasping for air, heart pounding. Her husband told her she snored. But Faulkenburg, 47, couldn’t tolerate ...
Why do I have to take a night off from CPAP?
There are many reasons that you may decide to take a night off from using your CPAP, whether you are sick with a cold, taking a trip camping in the woods, or flying off to vacation and not wanting to drag the machine along, you may be motivated to not use it temporarily.
How to use CPAP every night?
If you need help with your CPAP therapy , reach out to your board-certified sleep medicine specialist to ensure your treatment is optimized. Simple changes or additions may help you to use your device each and every night. This will maximize the benefit of the treatment and improve your well-being without any unnecessary risk. 1
Is sleep apnea a long term condition?
Instead, sleep apnea is a long-term risk factor for these medical consequences. It is a condition that is usually present for years. Much like the fact that one cigarette doesn’t necessarily kill you, but smoking for 30 years just might, it’s the cumulative exposure to the adverse effects of sleep apnea that harm health.
Can sleep apnea recur?
This might make it easier to breathe, even when you aren’t using it, such as during the day. If you take a break for several days, it may take time for the condition to incite the swelling that was previously present. Therefore, the symptoms or signs of sleep apnea may also be slow to recur. 1 .
Does CPAP work when you wear glasses?
Much like a pair of glasses, you may imagine that CPAP will work only when you wear it, but this may not be the complete story. In fact, CPAP may actually provide you a residual benefit, even when you aren’t using it for a few days.
Should I take a break from CPAP?
Getting Back to CPAP Therapy Is Recommended. Therefore, if you need to take a break from using your CPAP, don’t worry about the risks associated with it. Your breathing will simply return to your untreated tendency, and it is likely that you will initially derive a residual benefit from your recent use.
Can you die from not using CPAP?
Long-Term Health Consequences Take Time to Develop. Many people worry that not using CPAP for one night may put their health at risk. The risk of sudden death, stroke, or heart arrhythmia due to sleep apnea that occurs during one night of failed use is likely vanishingly small.
Oral Appliances
There are approximately 30 oral appliances used specifically to decrease the occurrence of sleep-related breathing disturbances. All are designed to reposition the mandible to maximize the diameter of the oropharynx.
Surgical Procedures
While there is no magic-bullet cure for OSAHS, surgery is, for many patients, a viable option. Obviously, one must weigh the discomfort of the surgical procedure against the individual patient’s degree of comfort with CPAP, remembering that a CPAP mask can be changed or removed, but surgery is permanent.
Conclusion
OSAHS is usually considered a lifelong condition, and the patient who drops out of medical care constitutes a worst-case scenario for sleep specialists. Data on unresolved OSAHS have shown the medical community what adverse physiological effects can occur.
What happens if one CPAP mask doesn't work?
Here are 10 common CPAP problems and what you can do about them: 1. The wrong size or style CPAP mask.
How to reduce anxiety with CPAP?
Relaxation exercises, such as progressive muscle relaxation, may help reduce anxiety related to CPAP use. If you're still feeling claustrophobic, talk to your doctor or CPAP supplier. It may help to get a different size mask or try a different style, such as one that uses nasal pillows. 6.
How to wear a CPAP mask while awake?
Then try wearing the mask and hose with the device turned on during the day while you're awake.
What is a CPAP machine?
A CPAP machine uses a hose and mask or nosepiece to deliver constant and steady air pressure. Common problems with CPAP include a leaky mask, trouble falling asleep, stuffy nose and a dry mouth.
Why is it important to use a CPAP?
The treatment is essential to avoiding complications of obstructive sleep apnea, such as heart problems and excessive daytime sleepiness.
Can a CPAP mask dry out your nose?
Check to make sure your mask fits well. A leaky mask can dry out your nose. If you have to tighten straps often to prevent air leakage, the mask does not fit properly. A CPAP device that features a heated humidifier, which attaches to the air pressure machine, can help.
Does a CPAP mask help with dry mouth?
Dry mouth. If you breathe through your mouth at night or sleep with your mouth open, some CPAP devices may worsen dry mouth. A chin strap may help keep your mouth closed and reduce the air leak if you wear a nasal mask. A full-face-mask-style device that covers your mouth and nose also may work well for you.
Who can prescribe a CPAP machine?
A person can get a Sleep Apnea diagnosis and a prescription for a CPAP machine from a General Practitioner , Sleep Doctor, Lung Doctor, an Ear, Nose, and Throat Specialist– just to name a few! Even a Dentist can write a prescription for a CPAP machine! The Pulmonary Specialist I checked in with provided me with a home sleep study.
Why do people use CPAP machines?
Benefits of using a CPAP machine can be lower blood pressure, better sleep, more energy and less chance of death or stroke during sleep.
What does CPAP stand for in sleep?
For those that are new to Sleep Apnea, “CPAP” is an acronym that stands for “Continuous Positive Airway Pressure ”, and is a medical device used to treat Sleep Apnea. Sleep Apnea is caused by the tongue and muscles of the throat relaxing during sleep, partially or completely blocking the airway.
How do you know if you need to clean a CPAP machine?
Does the machine smell? One of the clearest signs that the CPAP needs to be cleaned is if you notice a bad smell . The best way to determine this is to take a strong inhale of the mask.
Why is it important to clean a CPAP mask?
Cleaning your CPAP on a regular basis is important for a number of reasons, some of the main ones are simple. Your CPAP mask comes in direct contact with your skin, and your skin naturally produces a lot of oil.
What does it mean when you have a CPAP infection?
If you have begun to notice that you are experiencing more infections that are usual for you, this could be a sign that germs and bacteria have started to accumulate within your CPAP system. These germs can quite easily make their way into your body and cause a whole wealth of health problems.
What is the biological material on a CPAP mask?
Another common biological material that can be found on a CPAP mask which has not been cleaned are dead skin cells. Quite simple, they are not conducive to your mask working to its best, and as with the skin oils may leave bacteria.
Why does my face feel sore after using a CPAP mask?
A dirty CPAP mask filled with bacteria may cause some irritation to the skin of your face – quite simply because it has been in direct contact with it. You may notice redness, swelling, itching or even peeling of the skin. If this sounds familiar, cleaning the mask may relieve these problems. How does it look?
How long does a CPAP machine last?
The average CPAP machine should last for between 3 and 5 years, but improper cleaning can reduce this dramatically. You may be concerned that you aren’t able to tell when your CPAP machine needs a good clean, but as a rule of thumb some cleaning should take place every day.
Should you clean CPAP tubes?
You should also make a point of giving the tubes a daily clean in order to ensure that they are free from any build up that may cause mould and mildew. Maybe most importantly – if you use water with your CPAP machine, this should be changed daily and the chamber cleaned. If the water is not changed, there is a high risk ...
