cpap (continuous positive air pressure)

The "gold-standard" and most commonly prescribed method of treatment for obstructive sleep apnea is continuous positive air pressure or CPAP. A CPAP machine delivers air pressure of adjustable intensity through a nasal mask worn during sleep.

Nasal CPAP is a well established treatment that many people adapt to quickly, however, some patients may have difficulty.

There are three types of CPAP devices:

• Standard CPAP - Standard CPAP delivers a fixed pressure of room air. The air pressure forms a "splint" preventing the airway from collapsing during sleep. The pressure used is determined during a CPAP titration study.
• Bi-level CPAP - Bilevel devices use two different pressures to support the airway - a stronger pressure is delivered during inhalation and a lower pressure is used during exhalation. The change in pressure is determined by the patient's breathing pattern.
• Smart CPAP- SmartPAP machines automatically adjust the pressure in response to a patient's needs throughout the night.

Side effects of CPAP treatment include

• Nasal Congestion
• Conjunctivitis
• Sinus Involvement
• Skin Irritation
• Gastric Distension

CPAP Compliance is difficult to determine but studies indicate that it is influenced by a variety of factors including:

• severity of the sleep apnea
• quality of patient training and education
• initial success or problems
• participation in a support group
• claustrophobia
• follow-up and monitoring by health care professionals
• patient motivation
• use of humidification
• ramping feature of CPAP device (gradual increase in pressure as patient falls asleep)
• treatment reactions
• patient's age

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