A CPAP is a positive continuous pressure device in the airways that provides air at a predetermined pressure through a mask and is the first line treatment of Obstructive Sleep Apnea-Hypopnea Syndrome. It is used to maintain constant pressure in the airway during the entire respiratory cycle. It acts in a physiological way, fitting tightly over the patient’s nose, like a pneumatic splint, avoiding the collapse of the upper airway during inspiration and expiration. This basically prevents the obstruction of the airway during sleep.
Obstructive sleep apnea-hypopnea is a common disorder with a slight prevalence in middle-aged people. Several factors have been associated with an increase in its prevalence, such as obesity, age, and arterial hypertension. Among its symptoms are the recurrent collapse of the upper airway during sleep, resulting in repetitive episodes of dyspnea and frequent awakenings, which can lead to daytime drowsiness, decreased attention span and quality of life, and an increase in the prevalence of cardiovascular and cerebrovascular diseases, in addition to an increase in insulin resistance.
Treatment with CPAP is indicated in patients with an apnea-hypopnea index greater than thirty episodes per hour, regardless of the associated symptoms. It is also indicated in those who have an apnea-hypopnea index of five to thirty episodes per hour accompanied by symptoms such as daytime sleepiness, cognitive decline, mood changes, insomnia or cardiovascular diseases including high blood pressure, cardiovascular ischemic disease or cerebrovascular accident. So therefore, it is crucial to treat sleep apnea, as doing so can significantly improve a person’s quality of life.
Among the effects that allow the use of CPAP to treat sleep apnea are the reduction of sudden nocturnal awakenings, thus improving the quality of sleep and the daytime cognitive activity of the patients. It is not a curative treatment so it should be used daily and, in this sense, greater compliance with treatment will contribute to a greater improvement of symptoms in these patients.
A study published in Sleep Disorders confirms that after two years of treatment only half of the women studied are adherent to treatment. Other recent research published warns that adherence to CPAP is limited due to side effects and complications and that these patients are at risk of developing comorbidities such as high blood pressure, coronary artery disease or diabetes, and are exposed to increased risk of suffering from traffic or occupational accidents due to daytime sleepiness.
In any case, the treatment of this disorder should also include modification of certain lifestyle habits such as weight loss with a healthy and balanced diet, daily physical exercise, no smoking or consuming alcohol, other exciting substances, no sedative drugs. and follow some measures of sleep hygiene in terms of rest time.
CPAP therapy involves the use of specific equipment. The CPAP equipment is composed of a pressure generator, a nasal mask and a circuit that joins these two components. A valve allows eliminating the CO2 retained in the dead space of the circuit. For its part, the generator can apply pressures significant to improve conditions. Each patient will require pressure in this type of therapies, so this should be assessed through the polysomnographic study that will be done to the patient during the night of the diagnostic study or in an additional night. In this way, the specialist will be able to determine the maximum level of optimal pressure that avoids the obstructive events, restore the levels of arterial oxygen saturation and decrease the frequency of awakenings in the different stages of sleep.
When diagnosed with sleep apnea, the patient’s first concern is with adaptation to treatment, which is done indefinitely. This makes many people insecure and negative about using the new device.
Usually, the first contact with the device happens through the supplier. Thus, in addition to having the opportunity to know the treatment and the products better, it is possible to clarify many doubts about sleep therapy. Initially, it is natural to have resistance to the use of the device and face dilemmas of the type: how to have comfort using a device to sleep.
Adjust The Mask
The mask-fit is an important factor to maintain the comfort of treatment. Use a mask with adjustment inappropriate or misaligned can affect the seal and mostly well-being, as well as influence the integrity of the treatment with CPAP. Each mask model has an adjustment guide in the manual, which should be followed for both the user’s well-being and to increase the durability of the attachment, since use without proper adjustment can cause damage to the equipment such as ripping the cushion of silicone, for example.
Adjust The Tube
The tube is an accessory that can bother you at night, especially if the user has very restless sleep as he can get involved in the patient. The masks have 360-degree swivel connectors or a short flexible tube, so a solution is to pass it behind the pillow, or over the head of the bed. This way, the patient will be free to move and the tube will not bother.
Use The Right Pillow
The position in which the CPAP user sleeps for sleep may vary during sleep, and this happens unconsciously. Using the mask with a regular pillow, and lying on the side, for example, can move it or press it against the face causing air leakage and discomfort, and sometimes wake up with the face marked due to the position in which you slept. There are currently pillows appropriate for CPAP users, thanks to constant studies of these needs.
Clean The CPAP Accessories
The mask and accessories, after some time of use, can get strong odors, cause coryza, cough and nasal congestion. In addition, the mask cushion absorbs oil and debris from the skin, which affects sealing and comfort during sleep.
Therefore, the cushion should be sanitized daily, and other accessories such as the tube, fastener, and frame, can be cleaned weekly. This is to ensure that the CPAP and its accessories do not get dirty over a long period of time.