Snews Alert Online

Choosing the Most Appropriate CPAP

Continuous Positive Airway Pressure (CPAP) is an effective treatment for sleep disordered breathing such as Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS). CPAP involves the use of an adjustable blower unit, headgear and a mask usually covering the nose. Although various companies manufacture CPAP devices, all units are based on delivering the appropriate amount of pressurized air through the nose in order to prevent collapse of the upper airway. A nasal CPAP unit acts as a "pneumatic splint" by increasing pressure in the oropharyngeal airway, allowing air to flow in and out easily, thereby reducing the work of breathing. Consequently, microarousals due to apneic events are eliminated, sleep is less disrupted and patients feel more refreshed and energetic. Nasal CPAP use may help one to function more efficiently, alleviate daytime sleepiness and improve memory, motivation and job performance. In addition, the use of nasal CPAP can help prevent long-term complications of sleep-disordered breathing, such as hypertension, heart attack and stroke.

Equipment improvements and higher compliance
Patient satisfaction and long-term compliance have significantly improved over the last few years due to recent technological advances. To the joy of patients and their spouses, new nasal CPAP units are smaller, lighter and QUIETER. The informed use of adjustable (heated) humidifiers, available for all nasal CPAP units has been of great benefit to patient comfort and compliance. These humidifiers offer additional comfort by avoiding or minimizing nasal congestion, dryness and burning. Other units adjust automatically to mask leaks. Some offer a ramp option to facilitate initial entry into sleep with a lower pressure that builds to the prescribed pressure over a period of time (10, 20 or 30 minutes).

The more recent devices called bi-level positive airway pressure (BiPAP) have also improved greatly to meet specific patient needs and to minimize sleep disturbance. This device makes exhaling easier by reducing expiratory pressure to a third or half of the prescribed inspiratory pressure. Although this new technology seems promising, bi-level pressure devices are beneficial only in very specific cases. Many patients do not like or do not tolerate continuously changing pressures.

Traveling 
New technological advancements also make traveling easier. Patients who travel should not only consider the size and weight of the unit, but also the following features. Certain units come equipped with a specific suitcase, power cord and voltage for international travel. Other units offer an altitude adjustment and/or a built-in humidifier.

Before making your purchase 
All devices come with various options and patients should opt for the unit that best suits their needs. Here are a few suggestions to consider: How sensitive are you to noise level? Do you need a unit with or without a heated humidifier included? Do you need a device with a ramp, or one that adjusts automatically to mask leaks? Generally, benefits come with a price. Most health insurance plans let patients try out a nasal CPAP on a rental basis for the first three months before making the final purchase. This initial period allows patients to make sure they are using the best device for them.

Helpful Hints
-If you have severe apnea, always have an extra mask and hose available for back-up. 
-Use sediment free or distilled water to prevent deposits. Remember to clean and take proper care of your unit to prolong longevity and avoid contaminants (mold). 
-Have your unit checked once a year to ensure proper pressure setting.
-Take advantage of the instruction, training and follow-up offered by concerned health care professionals.

The following is a partial list of CPAP devices and their suppliers. For additional information, contact the Ohio Sleep Medicine Institute.
AirSep Corp. Remedy™ Renew is a lightweight, quiet CPAP unit, with low power and maintenance requirements. Easy portability for traveling and a delayed pressure ramp. 
DeVillbiss Healthcare Horizon LT presents an adjustable pressure delay time with a low level startup pressure option. Consistent pressure delivery by auto-adjusting to mask leaks and temperature changes.
Fisher & Paykel Healthcare HC200 is a lightweight, compact heated humidifier CPAP with pressure setting adjustable by patient for optimum performance and comfort. 
Healthdyne Technologies Tranquility Plus "the traveler's CPAP": automatic voltage adjustment and compensation for altitude changes, ramp option available.
Nellcor Puritan Bennett GoodKnight 318 Plus is a quiet, built-in humidifier CPAP with a Ramp option and a DC to AC converter allowing unit to work in cars an other vehicles. 
Nidek Medical Products Inc. Silenzio Delta is an ultra-quiet, bi-PAP with back up and breath support, leak detection, pressure ramp reset, carrying case and auto altitude adjust option.

Also view past articles:
INTRUDER OF THE NIGHT
ASLEEP at Work