Constant positive airway pressure (CPAP) is an effective method of treating obstructive sleep apnea syndrome. CPAP-therapy was introduced to clinical practice in 1981 by an Australian physician and Professor. Colin Sullivan for the treatment of obstructive sleep apnea syndrome.
The mechanism of action of the CPAP device is quite simple. A small compressor is used for creating constant air flow under a certain pressure in the airways during exhalation through a flexible tube and a nose mask. It is also used a humidifier that provides moisturizing and heats the air which enters the airways. This device does not allow the upper airways to be obstructed because of the constant positive air pressure and eliminates the main cause of the obstructive sleep apnea syndrome.
CPAP-therapy for patients with obstructive sleep apnea syndrome is now universally accepted. Before prescribing CPAP-therapy, a Polysomnography is required or in other words a Sleep Study. Polysomnography is a medical examination of a patient’s sleep with the use of specialized computer systems. Polysomnography allows calculating the apnea index and determining the severity of the disease.
The apnea index is the frequency of apnea episodes during one hour of sleep. Apnea index determines the severity of the obstructive sleep apnea syndrome. The apnea index is considered pathologically significant if there are more than 20 apnea episodes per hour, regardless of the presence or absence of clinical symptoms. By the way, even more than 5 attacks of sleep apnea episodes are considered to be threatening for a person with a gradual development of daytime drowsiness, memory impairment, psycho-emotional disorders, insomnia, development of cardiovascular diseases (arterial hypertension, coronary heart disease or stroke), and disturbance of cardiac rhythm.
The first session of CPAP-therapy is performed on the next night after a diagnostic polysomnography. The purpose of the first CPAP session is to select the minimum air pressure that eliminates obstructive apnea, snoring and other respiratory disturbances in all positions of the body and in all stages of sleep. During the first session of CPAP-therapy, the minimum set of parameters will be recorded: electroencephalography, electrooculography, electromyography, chest and abdominal movements, body position, snoring, electrocardiography, blood saturation. These parameters allow you to determine the work of the brain and the stage of sleep, which excludes the possibility of insufficient air pressure through undiagnosed wakefulness episodes.
The “golden rule” is to use CPAP machine every night during the entire time of sleep. Patients often follow this recommendation in severe forms of obstructive sleep apnea. In this case, there is an improvement in the quality of sleep and daytime activity. In the mild and moderate forms of the disease, the irritating effect of the mask and airflow may sometimes decrease the quality of sleep, nevertheless, there is a clear positive effect on daytime activity and on a number of other symptoms. One of the important advantages of CPAP-therapy is the absence of side effects.
Of course, sometimes in the beginning, as with any method of treatment, there may be side effects. Among the most common complaints, this may be irritation of the skin under the mask (about 50%), dryness of the mucous membrane of the nose and pharynx (about 30%), nasal congestion or rhinorrhea (about 25%), eye irritation (about 25%). However, these symptoms are not serious, they eventually disappear and do not interfere with the continuation of treatment. The use of more comfortable masks and heating moisturizers effectively eliminates all these side effects.