Monday Medical: Conquering the CPAP machine
For Steamboat Pilot & Today
If you’re one of the 22 million Americans suffering from sleep apnea, you may know what to do to treat it — but you may struggle following through.
Standard treatment for sleep apnea is to use a CPAP machine, which stands for continuous positive airway pressure, during sleep. The machine keeps the airways open, but it isn’t always easy for patients to start using.
“Wearing a mask on your face while sleeping is sometimes difficult to adjust to,” said Bill Moore, manager of respiratory therapy and UCHealth Sleep Lab in Steamboat Springs.
Below, Moore details how a CPAP machine works and how the additional assistance via the sleep lab can help people adjust.
What does a CPAP machine do?
With sleep apnea, the tissue above the space in the larynx near the vocal folds can lose its integrity and become floppy and collapse during sleep.
“It falls down and blocks the airway,” Moore said. “The CPAP machine provides warm, humidified positive pressure air to keep the airways open.”
The machine consists of a small airflow compressor to provide mild air pressure and a small tank of water to humidify the air. A tube brings the warm, moist air to a mask that you place over your face while sleeping.
Alternative treatments exist: there’s a surgery to remove the uvula and open the airway, an oral device that thrusts the lower jaw forward and an implant that pushes the tongue forward to prevent blocking.
“There are a variety of treatments, but the one that has the most medical evidence is CPAP,” Moore said.
Why is it important to use?
When sleep apnea is left unchecked, the collapse of the airways during sleep can cause oxygen levels to drop and keep people from reaching the deeper, restorative stage of sleep.
That can result in anxiety, depression, inability to focus, high blood pressure and daytime sleepiness and can contribute to a range of other diseases, such as congestive heart failure.
“There’s a long list of disorders that are associated with obstructive sleep apnea, and the list keeps growing,” Moore said. “If we treat the sleep apnea, we can help treat those other associated disorders.”
What are challenges of using a CPAP machine?
When a patient begins using a CPAP machine, they have 90 days to meet a compliance threshold, which means they must use the machine for least 30 consecutive nights, more than four hours a night.
“If you don’t meet that threshold, the insurance company can take the machine away,” Moore said. “We’re trying to help people who have recently started on CPAP meet that compliance threshold.”
Steps to help people use the machine successfully include finding the best-fitting mask and tweaking the settings of the CPAP machine. Patients may also get accustomed to the machine by using it while they’re awake, for instance, in the evening while they’re watching television.
It’s also important to set expectations and understand the importance of treating sleep apnea.
A small percentage of people will try a CPAP machine, sleep better than they have in years and start using the machine immediately. But for most people, it takes time.
“Our job is to help patients recognize the benefits,” Moore said. “Sometimes, that takes a week or 10 days. Sometimes, it takes a month or so. But once patients recognize the benefits, they’re CPAP users for life.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.
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