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The level of air pressure required to maintain your airway is determined during your sleep study. Your doctor will write a prescription for a CPAP machine set at a specific pressure (CPAP) or between a range of pressures (APAP).
The difference between CPAP and APAP relates to the pressure required to hold the upper airway open. CPAP is also known as fixed-pressure, which means a single pressure level is set by your sleep specialist based on the average or maximum pressure required to prevent your apneas and hypopneas. APAP devices, however, can automatically adjust the pressure required to keep your airway open (also known as automatic, or variable-pressure). Instead of a fixed-pressure (for example, 10cm), APAP machines are built to fluctuate within a range of pressures as they deliver air, constantly adjusting to the minimum pressure needed to keep airways open. APAP machines have a complex algorithm that detects on a breath-by-breath basis the pressure required at that moment to prevent apnea events. APAP devices deliver higher pressures during deep stages of sleep when needed, but then reduce pressure during the lighter stages of sleep making therapy reportedly more comfortable. An APAP prescription is typically a range between 4cm – 20cm of pressure.
Determining your suitability for CPAP or APAP is the responsibility of your sleep specialist.
It is likely that you will have to use CPAP therapy for the rest of your life. One night without treatment usually causes an immediate return of the same symptoms that motivated you to get help in the first place. Your long-term use of CPAP therapy may simply require an individual commitment, and it may require support from your partner or family.
The ramp function on a machine is a feature that allows for a gradual pressure build-up to your prescribed pressure. This improves comfort as the machine will remain at a lower pressure until you have fallen asleep.
The following guidelines are used in adults:
Normal: Fewer than 5 events per hour of sleep
Mild sleep apnea: 5 to 15 events per hour of sleep
Moderate sleep apnea: 15 to 30 events per hour of sleep
Severe sleep apnea: Greater than 30 events per hour of sleep
Most CPAP machines can be run on universal voltage. I would also advise using a surge protector when overseas. When flying always carry your CPAP machine onboard wth you, most airlines will let you take it without adding to carry on weight as it's medical equipment.
There are a few options when it comes to powering your CPAP device. Most makes and models can support 12v power with the addition of adaptors or have the ability to be run from a battery source. It's also a good idea when going on holiday to carry a small extension cord as the power points in hotels are not normally close to the beds.
It is possible for some people to come off their CPAP device through lifestyle changes and weight loss however the majority of people diagnosed will need to use the machine forever. If you feel like you have made these lifestyle changes it's still always best to undertake another sleep study before deciding to come off CPAP Therapy.
Yes - While symptoms will improve when using CPAP therapy you must always remember that this is a treatment and not a cure. If you stop using the therapy Apnea will return and then symptoms will come back.
If you are experiencing symptoms such as waking with a dry mouth or tongue, it is likely that your mouth may be opening while you are asleep. If you sleep with your mouth open, it is advisable to use either a full face mask, or a nasal mask with a chin strap, in order for CPAP therapy to be effective.
There are three types of masks available to use with your CPAP machine, and factors such as face shape, breathing habits, and air pressure prescription will determine which is right for you. CPAP therapy may be delivered through a nasal mask which seals around the nose, or a nasal pillow mask which seals at the nasal opening, or a full face mask which seals around both the nose and mouth and is recommended for people who tend to breath through their mouth during the night. Many innovative and comfortable options are available and advances in the delivery of CPAP therapy are continually occurring.
You will need to replace the air filter on your CPAP periodically. Check your user manual to see how often. Most devices require you to replace your air filter every six months, but some as often as every two months. If you live in a dusty environment, you may need to replace the air filter more often.
A stuffy nose can make it difficult to breathe during CPAP therapy, and mucus discharge may dirty the CPAP mask, especially if you use nasal pillows. Some sleep apnea patients on CPAP therapy may feel caught between a rock and a hard place; their cold or flu makes using a CPAP machine unpleasant, but not complying with therapy will increase their OSA symptoms. We have compiled a few tips that help CPAP users battle a cold or the flu.
Use a heated humidifier to reduce dryness and shrink swollen nasal passages
Use a nasal pillow mask to open up your sinus passages, or a full face mask if passage is still too congested
Use decongestants or nasal sprays to help clear your airways (speak to your doctor or a pharmacist to see if this is suitable for you)Elevate your head to allow mucus to drain
Wash your CPAP equipment regularly to prevent reinfection.
It is possible that the mask is pressing too hard on your face, often at the bridge of the nose or just under the nose. The solution is to wear the mask as loose as you can without breaking the air seal. Ensure the mask is central on your face (not tilted or lopsided), and tighten or loosen the straps as needed, until you can no longer feel any air escaping the mask. It is not advisable to use creams on your face at night before using your CPAP as this can prevent the ability to achieve an air seal. Following these steps can help to prevent sores and any air leakage issues with your mask.
You should always advise doctors and anaesthetist that you are using CPAP Therapy. When going to hospital always bring your own CPAP equipment with you as the hospital may not have anything to lend you.
Normally 2-3 weeks is enough time to get used to the machine and mask. At this point most people start to feel the benefits of using the therapy. As with anything though everyone is different and some people will take longer to get used to CPAP, The best thing to do is persist with the therapy and seek clinical help or advice if you need.
Suffering from sleep apnea can cause hormonal changes in the body making it more difficult to lose weight and at times easy to gain it. When you start using your CPAP machine the body will begin to regulate hormones properly again and along with increased energy and mood elevation you may notice your weight coming down.