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Continuous Positive Airway Pressure (CPAP)
The Problem
Fortyfive percent of normal adults snore at least occasionally, and 25
percent are habitual snorers. Problem snoring is more frequent in males and
overweight persons and it usually grows worse with age. Snoring sounds are
caused when there is an obstruction to the free flow of air through the passages
at the back of the mouth and nose.
Only recently have the adverse medical effects of snoring and its association
with Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS)
been recognized. Various methods are used to alleviate snoring and/or OSA. They
include behavior modification, sleep positioning, Continuous Positive Airway
Pressure (CPAP), Uvulopalatopharyngoplasty (UPPP), and Laser Assisted Uvula
Palatoplasty (LAUP), and jaw adjustment techniques.
What is Continuous Positive Airway Pressure (CPAP)?
Nasal CPAP delivers air into your airway through a specially designed nasal
mask or pillows. The mask does not breathe for you; the flow of air creates
enough pressure when you inhale to keep your airway open. CPAP is considered the
most effective nonsurgical treatment for the alleviation of snoring and
obstructive sleep apnea.
If your otolaryngologist determines that the CPAP treatment is right for you,
you will be required to wear the nasal mask every night. During this treatment,
you may have to undertake a significant change in lifestyle. That change could
consist of losing weight, quitting smoking, or adopting a new exercise
regimen.
Before the invention of the nasal CPAP, a recommended course of action for a
patient with sleep apnea or habitual snoring was a tracheostomy, or creating a
temporary opening in the windpipe. The CPAP treatment has been found to be
nearly 100 percent effective in eliminating sleep apnea and snoring when used
correctly and will eliminate the necessity of a surgical procedure.
So, if I use a nasal CPAP I will never need surgery?
With the exception of some patients with severe nasal obstruction, CPAP has
been found to be nearly 100 percent effective, although it does not cure the
problem. However, studies have shown that longterm compliance in wearing
the nasal CPAP is about 70 percent. Some people have found the device to be
claustrophobic or have difficulty using it when traveling. If you find that you
cannot wear a nasal CPAP each night, a surgical solution might be necessary.
Your otolaryngologist will advise you of the best course of action.
Should you consider CPAP?
If you have significant sleep apnea, you may be a prime for CPAP. Your
otolaryngologist will evaluate you and ask the following questions:
- Do you snore loudly and disturb your family and friends?
- Do you have daytime sleepiness?
- Do you wake up frequently in the middle of the night?
- Do you have frequent episodes of obstructed breathing during sleep?
- Do you have morning headaches or tiredness?
Suitability for CPAP use is determined after a review of your medical
history, lifestyle factors (alcohol and tobacco intake as well as exercise),
cardiovascular condition, and current medications. You will also receive a
physical and otorhinolaryngological (ear, nose, and throat) examination to
evaluate your airway.
Before receiving the nasal mask, you would need to have the proper CPAP
pressure set during a "sleep study." This will complete the evaluation necessary
for prescribing the appropriate treatment for your needs.
Return to "Snoring:
Not Funny, Not Hopeless"
© 2000 AAO-HNS,
Inc.
© 2004 AAO-HNS/AAO-HNSF
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