Continuous Positive Airway Pressure machine (Photo credit: Wikipedia)
While most people associate the Continuous Positive Airway Pressure or CPAP machine with Sleep Apnea, it is also used to treat other conditions. Because the machine helps keep airways open with a constant flow of air, it is also used to help people with respiratory difficulties and for those in the hospital who need assistance with oxygen and carbon dioxide exchange.
How it Works
The CPAP machine delivers a constant stream of air into a mask or nasal pillow that provides enough air pressure to keep airways open during sleep. Although it appears that the constant flow of air keeps the airway open, it is actually the air pressure created by the air input in combination with the sealed mask that produces this result. CPAP machines can be used with a variety of delivery mechanisms including a nasal pillow, nose mask, or full face mask. Regardless of which kind of mask is used, the most important consideration is that the mask can be sealed to the face in order to create and maintain the required air pressure.
The amount of pressure needed to achieve the desired result is determined on an individual basis. If the CPAP is being used to treat sleep apnea, the required pressure is determined during a sleep study and usually ranges from 4 to 14 cmH2O (centimeters of water, used to measure air pressure). Higher pressures are commonly used, though the device mode will often be switched to BiLevel PAP in order make it more comfortable to breathe.
Conditions it is Used to Treat
Although most commonly connected to the treatment of sleep apnea, CPAP is also used to treat the following conditions:
- Congestive heart failure
- Respiratory failure
- Ventilation needed for neuromuscular conditions
- Hypoxia
- COPD
- Assisting with breathing in the neo-natal intensive care unit
Common Problems Using the Machine
The primary issue people have when using a CPAP machine at home is discomfort experienced when wearing the mask. Some people find it too constricting and others find the sensation of exhaling against the air pressure difficult or unpleasant.
People who are prone to anxiety or claustrophobia may have more trouble acclimating to the use of a CPAP machine than others. However, this can often be alleviated with desensitization. The best first option is to come in during the day and try CPAP, apart from a sleep study. Using CPAP without the wires required during a sleep study and on a lower pressure than prescribed for sleep, while also getting to see the different types of masks and try out different pressure settings, will greatly assist in easing anxieties.
Other complications that increase the likelihood of noncompliance include nasal congestion, runny nose, sinus infections, bronchitis, and dry eyes or nasal passages. It is important to note, however, that according to the National Sleep Foundation, these complications are generally temporary and will disappear as the person acclimates to the use of the machine. Serious side effects of CPAP usage are rarely noted and therefore not a contributing factor to people choosing not to use the machine.
Keys to Compliance
The fit of the mask is one of the most important factors in achieving compliance. There are many different masks available that come in a variety of shapes and sizes and some are specifically designed to maximize comfort. Finding the right mask improves the likelihood that the machine will be used consistently. Cognitive behavioral therapy at the start of CPAP treatment may also aid in compliance especially for those suffering from anxiety over using the machine.
