CPAP (pronounced "see-pap") is short for "continuous positive airway pressure." Positive airway pressure therapy is the most effective noninvasive treatment for OSA. CPAP systems consist of a flow generator, air tubing, and a mask (usually a nasal mask). The flow generator pushes air through the tubing and nasal mask. The air passes through your nose and into your throat, where the slight pressure keeps your upper airway open. The low air pressure does not interfere with breathing – though some people need a few nights to get used to the sensation of positive airflow. Many clinicians describe this therapy as a pneumatic splint – literally an air splint to hold your throat open.
The following diagram illustrates a pneumatically splinted upper airway. The tongue and soft tissue have fallen to the back of the throat, but the pressure of the air pumped in by the flow generator holds the upper airway open.
A Treatment From Down Under Colin E. Sullivan, a pulmonologist and researcher at the University of Sydney in Australia, began testing CPAP therapy in June of 1980. His first patient went home with a CPAP device in February of 1981. Recognized internationally as the inventor of CPAP therapy for OSA, Dr. Sullivan continues his work today, conducting research and designing positive airway pressure devices for the treatment of sleep-disordered breathing (SDB).
In the 20 years that have elapsed since Dr. Sullivan created the first CPAP device, CPAP therapy has become the first line of treatment for patients with OSA.
Beginning CPAP Treatment Positive airway pressure therapy is the safest and most effective therapy available for people with OSA. CPAP was the first of these therapies, and as evidenced by countless testimonials, it can mean the beginning of a vastly better life.
The most important steps with CPAP therapy are the initial steps. The proper treatment pressure, a comfortable system, and good education often mean the difference between success and failure for many CPAP users. Success means sleeping better and getting more enjoyment out of waking hours, and it can also mean lowering blood pressure and resolving the symptoms associated with OSA. Successful CPAP users report feeling improvements in
A titration study usually takes place in a sleep clinic and typically involves one night of monitoring by a sleep technician who adjusts CPAP levels in response to SDB events, such as snoring, hypopneas, and obstructive apneas. The goal is to find the lowest pressure that will prevent apneas, hypopneas, and snoring during all stages of sleep. The study takes several hours during the night because a patient's pressure needs change as the night progresses. Pressure needs tend to be at their highest during REM sleep, but each REM cycle can differ slightly.
Flow Generators A flow generator pulls air through a filter and provides a set air pressure through a mask system to the CPAP user. Most CPAP devices fit conveniently on a nightstand.
Mask System A mask system includes the mask and the air tubing. Air tubing is fairly standard, but masks hold the most competitive portion of the CPAP market. There exists a much broader range of comfort levels in current mask systems than in flow generators.
Two basic kinds of mask systems exist:
CPAP Therapy Side Effects and Their Treatments