Health Issue: Sleep Apnea

CPAP is the most widely recommended treatment for moderate to severe obstructive sleep apnea. CPAP entails wearing a mask-like device while you sleep, which provides pressurized air to prevent the airway from collapsing. Most CPAP units are the size of a tissue box and many now come with a built in humidifier for comfort.

While CPAP works very well in preventing apnea symptoms, many people find the apparatus uncomfortable and difficult to use. Luckily, recent advancements to CPAP technology have made these once cumbersome devices much lighter, quieter and much more comfortable. Recent refinements include options such as:

• “Bilevel PAP,” which switches from higher to lower air pressure during the exhalation, making breathing easier for some,
• “AutoPAP”, which uses an internal regulator that adjusts pressure rather than remaining at one fixed setting.

Different types of masks are available and can make using the device more comfortable
CPAP can cost $1000 or more – but they are usually effective when used correctly. Unfortunately, many people don’t receive proper coaching and guidance for using these breathing devices, and give up on them quickly.

The following tips may help you use CPAP more comfortably and successfully:  

• Take your time. Start by using your CPAP for short periods during the day. Use the “ramp” setting to gradually increase air pressure.
• Make small adjustments to the mask, tubing and straps to find the right fit. Soft pads are available to cover the straps and reduce skin irritation.
• Try masks of different sizes and types. A full mask might work better if you breathe through your mouth. A mask with nasal pillows should decrease nose discomfort. A mask with a chin strap will help keep your mouth closed and reduce throat irritation.
• Put your CPAP unit under the bed if the noise bothers you.
• Use a humidifier with the CPAP unit (or get a unit with a humidifier) to decrease dryness and skin irritation. Try a special face moisturizer for dry skin.
• Try a saline nasal spray or a nasal decongestant for nasal congestion.
• Keep your mask, tubing and headgear clean. Replace CPAP and humidifier filters regularly.
• Work with your doctor or sleep specialist to ensure the right fit and find the right settings on your CPAP unit.
• Find a support group or others who use CPAP to exchange tips and give and receive moral support.
• Use the CPAP consistently – every night and during every nap. This will make the adjustment easier and ensure maximum benefit.

Surgery can increase the size of your airway. The surgeon may remove tonsils, adenoids, or excess tissue at the back of the throat or inside the nose. Or, the surgeon may reconstruct the jaw to enlarge the upper airway.

Surgery may be an effective option for some, and can even provide permanent relief from symptoms. However, any surgery carries risks of surgical complications and infections, and in some rare cases, symptoms can become worse after surgery. If you have exhausted other apnea treatment options, you may want to discuss surgical options with your doctor or sleep specialist.