CPAP Therapy: Help for Obstructive Sleep Apnea
We take breathing for granted. It is only when we snore at night, wake up tired, or have breathing problems that we become aware of the importance of each breath and begin to focus on our breathing. CPAP therapy is a breathing therapy that takes place during sleep. It is considered a standard therapy and is the most frequently used method for obstructive sleep apnea (OSA), while also counteracting snoring and nocturnal breathing pauses.
- CPAP stands for Continuous Positive Airway Pressure. During CPAP therapy, the patient is continuously treated with positive pressure while sleeping. The pressure remains constant during inhalation and exhalation.
- In contrast, BiLevel (Bilevel Positive Airway Pressure) means that the sleep therapy device operates at different pressure levels during inhalation and exhalation, thereby facilitating exhalation at higher therapy pressures.
- In APAP therapy (Automatic Positive Airway Pressure), the sleep therapy device also generates a constant pressure during inhalation and exhalation. However, this pressure is regularly adjusted to the sleep apnea patient's breathing by measuring various parameters.
CPAP is often used as a generic term for CPAP, APAP, and BiLevel. Treatment with CPAP is a reliable and widely used method for treating moderate to severe sleep apnea1, which restores vital sleep to patients and contributes to an improved quality of life.
What happens during sleep apnea?
To understand how CPAP therapy works, it is important to understand what sleep apnea actually is. Sleep apnea is a widespread and often undiagnosed sleep disorder, the typical symptoms of which are breathing pauses during sleep and accompanying snoring.
There are three different types of sleep apnea:
Obstructive sleep apnea (OSA), central sleep apnea (CSA), and mixed sleep apnea.
The cause of the breathing pauses, also known as apnea (from the ancient Greek "non-breathing"), is that the muscles of the pharynx collapse during sleep and block the airways. As a result, airflow is prevented and briefly stops. These regular apneas repeatedly interrupt sleep, so that neither physical nor mental recovery can take place. In CSA, airflow is interrupted by a lack of signal from the brain.
However, it should be noted that not every snorer also suffers from sleep apnea syndrome. If you are a heavy snorer and regularly wake up with headaches, are unfocused during the day, or experience severe fatigue, these could be signs of sleep apnea. You should urgently clarify this with your doctor. Interesting to know: the causes of the typical snoring sound are fluttering movements of the palate, uvula, and sometimes also the base of the tongue, which are caused by the narrow space during inhalation and exhalation.
How CPAP therapy works
In this form of sleep apnea therapy, room air is continuously pumped into the airways of affected individuals with slight overpressure. This pressure is generated by a CPAP device, which usually stands on the bedside table in the immediate vicinity of the patient. The device is connected to the CPAP mask via a hose. The generated overpressure ensures that the airways remain open. The result is that the frequency of breathing pauses and thus the interruption of sleep significantly decreases. This increases the oxygen content in the blood and effectively improves sleep quality.
What is needed for therapy?
For sleep apnea therapy with CPAP, a so-called CPAP device and a corresponding CPAP mask are needed, which are available in different variations (nasal masks, nasal pillow masks, and full face masks). The device delivers continuous therapeutic pressure to the patient's airways via a hose and mask. Many CPAP devices have integrated humidifiers that ensure the therapeutic air is enriched with water vapor. This prevents the mucous membranes from drying out during sleep apnea therapy with CPAP, APAP, or BiLevel, if necessary. An important component is also the air filter, which is located in the device and ensures the purification of the inhaled air.
When is CPAP therapy useful?
Sleep therapy with positive pressure treatment is primarily intended for patients with moderate to severe sleep apnea. Even those with mild obstructive sleep apnea and noticeable symptoms or coexisting conditions (e.g., cardiovascular diseases) can benefit from this sleep therapy.
Important to know: As a rule, CPAP therapy is not used for "mere" snorers who do not have breathing pauses.
Possible side effects
As with other therapies, CPAP therapy is not entirely free of side effects. The biggest challenge for every affected person at the beginning of therapy is getting used to sleeping with a mask. The noise of the device is sometimes perceived as disturbing. Some patients report that they suffer from pain, uncomfortable pressure points, and skin irritation because of the mask. These complaints can usually be prevented by finding the right mask for the patient and adjusting it correctly. The constant overpressure can lead to further side effects, such as dry mouth, nose, or eyes. If the acclimatization phase is over and the treatment with a CPAP device and mask is continuously continued, those affected benefit from the therapy. The result is a significant improvement in the quality of life.
Duration of CPAP therapy
Sleep apnea is generally not curable. However, sleep apnea therapy with CPAP prevents the symptoms. The therapy is therefore a continuous treatment. It is therefore recommended that sleep apnea patients wear the CPAP mask every night without exception.
Further sleep apnea therapies
In addition to CPAP treatment and wearing a CPAP mask, there are other ways to alleviate the symptoms of sleep apnea. An alternative for patients who cannot cope with mask therapy are anti-snoring splints or mandibular advancement devices (MADs), which are fitted by a dentist or orthodontist. Such a dental splint supports the displacement of the lower jaw during sleep. This is moved forward by a few millimeters by means of the splint to keep the airways open and thus prevent breathing pauses and snoring. The anti-snoring splint is suitable for almost everyone who suffers from loud snoring or who has been diagnosed with mild to moderate obstructive sleep apnea. Even those who suffer from severe OSA and cannot tolerate CPAP therapy can, for example, use the Narval CC mandibular advancement device from ResMed as an alternative. It also represents a good option for those affected who travel a lot, as it is very compact compared to a CPAP device. If you are interested in an MAD, please contact us or find out more here. Alternatively, depending on the initial situation, patients may also be recommended surgery. Please note: The information on this page does not constitute medical advice and therefore cannot replace a consultation with a doctor. Only a trained medical professional can reliably advise you according to your individual needs and initiate appropriate treatment.