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CPAP: (Continuous Positive Airway Pressure)
The most commonly prescribed treatment for obstructive sleep apnea is continuous positive airway pressure (CPAP). A CPAP device delivers air pressure through a nasal mask that is worn while sleeping. For many patients, CPAP therapy dramatically improves their daytime functioning as well as their general health. CPAP has been considered the gold standard in treatment and a non-invasive therapy for managing OSA. The pressure setting of the device is typically determined with a titration sleep study. Introduced over 30 years ago as the only non-surgical treatment for OSA, the devices have become smaller, quieter and provide many more features to enhance compliance than those issued just a few years ago.
How does Continuous Positive Airway Pressure (CPAP) therapy work?
The CPAP device gently blows normal room air at a fixed pressure through a tube which attaches to a small comfortable mask worn over the nose, or both the nose and mouth. The gentle flow of air is carefully measured to be just enough to keep the airway opened and unobstructed. The airflow also prevents snoring, so sleep is quieter for both the patient and the bed partner.
Many patients with obstructive sleep apnea experience long and deeper sleep once they start on CPAP. For the first week or so after starting to use the device, patients can spend a great deal of time in deep sleep. Patients often report that there is a dramatic increase of daytime alertness and energy after just a few nights with CPAP.
Auto CPAP
Responds to the individual's needs throughout the night providing a range of pressures that support the airway in order to keep it open. As an example, some patients prefer to start at a lower pressure, allowing them to fall asleep more easily. In order to keep their airway open, the device will increase pressures just enough to keep the airway open and prevent the patient from awakening. APAP adjusts automatically to the changing needs throughout the night for each patient.
Bi-level
As the name implies, these devices provide two levels of pressures; a higher pressure during inhalation, and a lower pressure during exhalation. This form of pressure support assists patients who have difficulty adjusting to a single pressure CPAP device. It is also very helpful for patients who are obese and suffer from shallow or inadequate air in the lungs.
Bi-level Auto
Provides a higher inspiratory pressure and a lower expiratory pressure, automatically adjusting to the changing needs of the patient throughout the night. Patients who have had difficulty tolerating a fixed CPAP pressure may find this device more comfortable.
Bi-Level with Back-Up Rate
In addition to providing a separate higher inspiratory pressure and a lower expiratory pressure, this device also provides a back-up rate that "kicks in" a breath if a patient stops breathing. This device is commonly used for patients with severe respiratory conditions such as restrictive airway disease or neuromuscular conditions such as ALS ("Lou Gehrig's Disease").
Adaptive Servo Ventilation
This is a sophisticated device for rare cases when the CPAP or Bi-level treatment itself brings on additional Central Apnea events. This dual condition is called Complex Sleep Apnea. Adaptive Servo Ventilators monitor each breath and adapt to prevent Central Sleep Apnea events from occurring.
