ORAL APPLIANCE THERAPY FOR SNORING AND SLEEP APNEA

cpap (continuous positive air pressure)

CPAP

The "gold-standard" and most commonly prescribed method of treatment for obstructive sleep apnea is continuous positive air pressure or CPAP. A CPAP machine delivers air pressure of adjustable intensity through a nasal mask worn during sleep.

Nasal CPAP is a well established treatment that many people adapt to quickly, however, some patients may have difficulty.

There are three types of CPAP devices:

  • Standard CPAP - Standard CPAP delivers a fixed pressure of room air. The air pressure forms a "splint" preventing the airway from collapsing during sleep. The pressure used is determined during a CPAP titration study.
  • Bi-level CPAP - Bilevel devices use two different pressures to support the airway - a stronger pressure is delivered during inhalation and a lower pressure is used during exhalation. The change in pressure is determined by the patient's breathing pattern.
  • Smart CPAP- SmartPAP machines automatically adjust the pressure in response to a patient's needs throughout the night.

Side effects of CPAP treatment include

  • Nasal Congestion
  • Conjunctivitis
  • Sinus Involvement
  • Skin Irritation
  • Gastric Distension

CPAP Compliance is difficult to determine but studies indicate that it is influenced by a variety of factors including:

  • severity of the sleep apnea
  • quality of patient training and education
  • initial success or problems
  • participation in a support group
  • claustrophobia
  • follow-up and monitoring by health care professionals
  • patient motivation
  • use of humidification
  • ramping feature of CPAP device (gradual increase in pressure as patient falls asleep)
  • treatment reactions
  • patient's age

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