Continuous Positive Airway (CPAP Machine) is the most widely prescribed equipment for the treatment of sleep apnea.
It has also been advocated in the treatment of patients with severe COVID-19 infection who can not maintain adequate oxygenation despite high-flow oxygen administration.
CPAP Machine use for Sleep Apnea:
Sleep apnea is a medical disorder in which a person’s breathing continuously stops and restarts while sleeping.
It is a serious condition that has an impact on a person’s daily life. Sleep apnea affects those who snore loudly or feel exhausted even after a full night’s sleep.
The most common type of sleep apnea is Obstructive Sleep Apnea (OSA) which causes breathing disruptions or pauses, that occurs when your throat or airways collapse or become momentarily blocked.
As you sleep, a CPAP machine delivers a continuous stream of oxygen to your nose and mouth. This helps you breathe correctly by keeping your airways open.
Because nighttime hypoxemia is treated, patients are less likely to develop complications secondary to sleep apnea such as pulmonary hypertension and cardiac arrhythmias.
CPAP machine used in Severe COVID-19 infection:
COVID-19 infection is associated with severe hypoxemia. Initially, all patients are managed by providing them with supplemental oxygen via nasal prongs or face masks. However, as the severity of the disease progresses, patients are unable to maintain oxygenation.
When the patients are unable to maintain oxygen despite high flow supplementary nasal oxygen and non-rebreathing masks with oxygen reservoir bags, such patients may either be given the option of mechanical ventilation or a CPAP machine.
Usually, for patients who are conscious, a CPAP machine is preferred since it provides non-invasive oxygen support.
CPAP machine use in such patients might prevent the person from getting invasive mechanical ventilation.
What are the Different Parts of a CPAP Machine:
A CPAP machine contains the following parts:
A mask: Masks are mainly of three types:
Nasal pillow mask:
- A tiny cushion covers your nostril area in this sort of mask. Prongs that fit into the nostrils might also be present.
- This mask makes it easy to wear glasses. It’s also useful if you have a lot of facial hair that would make a larger mask too tight to wear.
- This is a padded mask that completely covers your nose.
- If you move around a lot when sleeping, this might be a better option. It delivers a high-pressure airstream.
- The mouth and nose are covered by this type, which is formed like a triangle.
- If you breathe via your mouth while sleeping or if you have a blockage in your airway, your doctor may recommend this mask.
- This links the mask to the CPAP machine’s motor.
- The air is blown into the tube by a motor.
How does CPAP Machine Work?
The compressor (motor) in a CPAP machine produces a constant stream of pressurized air that passes through an air filter and into a flexible tube.
The tube pushes clean air into the mask. The airstream from the CPAP machine pushes against any obstructions in your airways while you sleep, allowing ample oxygen to reach your lungs.
Your breathing does not pause since there is nothing blocking the flow of oxygen. As a result, you don’t have to wake up every time you want to continue breathing.
Benefits of using a CPAP machine:
CPAP machine is the most effective non-surgical treatment of sleep apnea. It has many benefits such as:
One study that compared the treatments for Obstructive Sleep Apnea (OSA) concluded that the CPAP machine was superior to oral applications or conservative treatment measures in improving daytime sleep, overall sleep parameters, and quality of life [Ref]
Another study demonstrated that OSA plays a causal role in hypertension, and CPAP has been found to lower blood pressure in both normotensive and hypertensive people with severe OSA [Ref]
The use of CPAP machines in cardiac patients is associated with a decreased morbidity and mortality rate [Ref].
Most of the research has demonstrated the effect of CPAP machines on middle-aged people. One study that assessed its effectiveness on older adults concluded that the CPAP machine is a very effective treatment for elders with sleep apnea [Ref].
Some studies suggest that obesity is also a cause of sleep apnea. One controlled trial suggests that with the usage of a CPAP machine, there has been a 10 % decrease in body weight and a 32% increase in AHI (apnoea–hypopnoea index). Although further research is required in this regard.[Ref]
The use of CPAP machines has also been linked to a decrease in depression and anxiety levels.[Ref].
Common complications of using a CPAP machine:
The machine won’t work properly for you if any of these complications exist:
Wrong size or style of the mask:
- Carefully listen to the instructions of your doctor to make sure you get the mask of your size and according to your face shape.
- Try the different above-mentioned types of masks and choose the one that fits you the best. A properly fitted mask must not cause discomfort or pain.
Difficulty in getting used to wearing the machine
- You must try wearing the CPAP machine for short intervals when you are awake. This way you will get better used to it and it won’t cause discomfort when you wear it for a long time.
Difficulty with high air pressure:
- You can overcome this difficulty by using a machine that has a pressure-adjusting feature. This way you can start with low pressure. The machine will automatically increase the pressure slowly.
- Although a humidifier can help get rid of this condition. But this is often caused if the mask is leaky, buying a mask of your size might help overcome the problem.
Difficulty falling asleep:
- At the start, it might be difficult to sleep with a CPAP machine. Using it in the daytime might help. Avoiding caffeine might also help in getting better sleep with a CPAP machine.
- This might be a problem for people who breathe through their mouths.
- A chin strap might help in keeping the mouth close and reduce the air leak.
- This can also be treated with a full-face mask, that covers the mouth and nose.
Removing the CPAP machine unintentionally during sleep:
- To avoid this problem, you must try your mask and make sure it fits you well.
- If it is too tight you might get irritated and eventually pull it off during your sleep.
Maintaining pressure at high altitudes:
- This complication is mostly faced by people who travel or live at high altitudes. Many CPAP machines fail to maintain pressure at high altitudes.
- To overcome this, you just need a CPAP machine with a pressure-adjusting feature.
How to clean the CPAP Machine:
It’s necessary to clean the equipment according to the directions for use that come with it. Inadequate or improper maintenance can make your sleep therapy ineffective and cause equipment damage.
If you’ve been sick, wash your mask, tubing, humidifier, and filter on a regular basis until your cold, flu, or virus symptoms have passed. This can assist in reducing the amount of time you spend feeling ill.
In order to make it work properly, it must be washed once a week.