Treatment – Mechanical Devices
All treatments attempt to increase the airway size and ease the flow of air to the lungs during sleep.
Continuous Positive Airway Pressure
Continuous Positive Airway Pressure (CPAP) is the primary treatment for people with obstructive sleep apnea. It is the gold standard against which other treatments are measured. Unfortunately, compliance is a problem. Some people will not or cannot tolerate it. Reports vary but approximately 50% of those treated do not use it after a couple of years. CPAP has been proven over the past 20 years as a reliable treatment when used correctly. It is a device that controls apnea by providing a stream of air, under slight pressure, through a mask or tube into your nasal passage. This positive air pressure inflates the airway, thus preventing airway collapse. A small air compressor sits beside the bed.
CPAP treatment provides immediate results. Use of this device requires a sleep study to determine the most effective air pressure to use. It works well if you can train yourself to wear it! Many studies have documented that patients use CPAP for only part of the night. The use of CPAP for the entire sleep period is critical to the successful resolution of the problem. Patients who use CPAP for only part of the night are left untreated for that portion of the night spent without CPAP, thus experiencing a recurrence of sleep fragmentation and reductions of oxygen levels in the blood.
The recorded negative comments about this treatment are that is uncomfortable, inconvenient, noisy, restrictive, and that it dries out the nose, mouth, and/or throat.
Newer models of CPAP devices are quieter and can provide two levels of air pressure one for inhaling and one for exhaling (BiPAP). In addition, a humidifying feature is available to alleviate the complaints of dryness in the nose, mouth, and/or throat.
Periodic monitoring by a sleep physician is essential to ensure the device's continued effectiveness.