CPAP

Continuous positive airway pressure (CPAP) is the treatment of choice for sleep apnoea. A pressure of 4-20cm of water is applied to the mouth or nose continuously throughout sleep to prevent airway collapse and consequently airway occlusion.

CPAP will reverse obstructive apnoeas and put an end to chronic hypercapnia (excess of carbon dioxide in the blood leading to oxygen desaturation) and life-threatening hypoxia. Reversal of daytime hypersomnolence may be dramatic.

Follow a few simple steps to get used to your new CPAP machine. If you had no problems using the CPAP machine at the sleep lab just move down to steps 4 or 5.

•  Getting used to the mask

While you are awake wear your CPAP mask. You may need to do this for a few days until the mask no longer feels uncomfortable to wear.

•  Switching the machine on

During the day while you are watching TV, listening to the radio, reading a book or performing other sedentary activity turn the machine on. To get use to the machine, start by using the Ramp mode (most machines should have this button). By hitting the Ramp mode the machine starts at a low pressure for 20 minutes. After this time the machine will automatically rise to the prescribed pressure. Hitting the ramp switch several times allows you to become comfortable with your CPAP. Try this a few times - until you get used to the CPAP machine.

•  Naps with your CPAP

Now you are ready to extend the use of your CPAP. Try lying down with your CPAP during scheduled one hour naps at home. Look for a nice place to take a nap and try falling asleep with your CPAP machine on. Once you are able to initiate sleep, you can move on to steps 4 and 5.

•  First night

You are once step closer to sleeping with your CPAP machine, don't give up yet. It may be little difficult at first but once you get through it you will feel great in the morning. Use the CPAP during the initial 3-4 hours of nocturnal sleep. When you can no longer stand using the CPAP (at about 3 hours), take the mask off and sleep for the rest of the night without it.

•  Getting through the night

Step number 4 is where many users have trouble. The problem is breaking thorough the 3 rd hour. Many patients want to pull the mask off at exactly the same time each night. Now is the time to push yourself through the entire night. If you wake up at 2 or 3am take a short break (5-10mins), and go to the bathroom or have some water. When you come back, start using the CPAP again in Ramp mode (remember you did this while training). Keep using the ramp mode if you need to all night or until the time when you normally get up. If you make yourself comfortable and relaxed, you will fall asleep.

It is extremely important that you eventually sleep the entire night with the CPAP machine on. You will not get the full effect by taking the CPAP off at 2-3am.

Remember that it may take about 2 weeks before you can use the CPAP machine the entire night. But after that you will not be able to sleep without it. It is also important to remember that once you start this process DO NOT take a night off. One night may turn into a week, and a week could turn into not doing it at all.

Interesting information

CPAP was invented by Professor Colin Sullivan and co-workers at Sydney University in 1981. Professor Sullivan had a theory that the obstruction of the airways could be removed if CPAP could be applied via the nose. To test the theory, Professor Sullivan "glued" tubes into the nostrils of a patient. A vacuum motor running in reverse mode supplied the pressure - this marks the beginning of the CPAP machine. At present there are a number of CPAP machines available to patients. These machines are light and some are capable of storing usage information, which can later be downloaded for the doctor to see.

 

Old CPAP pump
Nasal pillows