The Role of APAP in Managing Obstructive Sleep Apnea

Obstructive sleep apnea, or OSA, is a condition that causes the air passage to become obstructed as the body relaxes during sleep. Millions of Americans suffer from the disorder with cases ranging from mild to extreme but many simply accept OSA and the problems that accompany the condition.

As of yet, there is no cure for the disorder -- but it can be successfully controlled and the effects minimized with APAP (automatic positive airway pressure) treatment.  If prescribed, an APAP can be scripted as a CPAP with one fixed pressure.

Cause and Effect

There is no one specific cause of OSA but it is generally attributed to several contributory factors. A person's lifestyle, fitness, diet, weight, pre-existing medical conditions, general health and bad habits have all been linked to the onset of obstructive sleep apnea.

To minimize the chances of suffering from OSA:

  • Maintain a proper body weight
  • Exercise regularly
  • Follow a balanced, healthy diet
  • Do not smoke or use tobacco products
  • Drink alcohol only in moderation
  • Take prescribed medications for underlying medical conditions 

Although the condition can affect any person, at any age, at any time (although most prevalent  in middle-age), it is far less common  in healthy, fit and active individuals. In mild cases, a simple change of lifestyle and habits may be enough to completely banish the problem.

OSA is not a problem that will simply disappear in time (although this can happen) and long-term sufferers put themselves at higher risk of:

  • Heart problems
  • Stroke
  • Blood pressure issues
  • Fatigue
  • Difficulty concentrating
  • Drowsy driving & traffic accidents

Depending on the severity of the condition, there are several options that can be used to alleviate OSA. Sleep researchers and specialists have found that using a APAP is the best obstructive sleep apnea treatment program.

APAP Treatment

As the name suggests, automatic positive airway pressure devices work by delivering a stream of pressurized air to the throat which forces the air passage to remain open. 

APAP devices comprise a compressor which takes in and filters air, a system of tubing which takes the pressurized air up to a mask which covers the nose, mouth or both.

OSA causes the airway to constrict, or even close, multiple times during sleep as the throat and neck muscles relax. 

The sudden lack of oxygen causes a reaction in the brain and alerts the body that something is amiss. This results in gasping for breath -- and the patient wakes momentarily as the body tries to resolve the problem. 

In extreme cases, these awakenings can happen hundreds of times a night and leave the sufferer feeling drained and tired -- despite having spent the optimum amount of hours in bed.

The pressurized air delivered by an APAP device is regulated to force sufficient air to the mouth, nose and throat that the passage remains open -- thus avoiding the intermittent pauses in breathing associated with OSA.

Machines and Masks

An Auto Positive Airway Pressure machine is just one of several types of positive airway pressure devices available but by far the most commonly used. This type of device employs a range of varying pressures to prevent a patient from snoring and/or obstructing while asleep.  Other devices of this type include:

Bi-Level PAP which employs different pressure settings for inhalation and exhalation.

CPAP is a device which employs a set single pressure. Masks used with positive airway pressure (PAP) devices will depend on such factors as comfort, ease of use and the user's breathing habits i.e. whether they breathe mainly through the nose, mouth or a combination of both.

The three mask types are:

Nasal. A nasal mask covers the nose and is the most suitable option for OSA sufferers who breathe mainly through the nose.

Nasal Pillow. This mask covers just the entrances to the nostrils and often just has two small tubes that sit into the nostrils during sleep.

Full. A full mask is the largest of the three types but prevents leaks from the mask as it covers both the mouth and the nose.  A very popular option provides both a nasal option that also covers the mouth as many people mouth breathe without knowing it.  Both ResMed and Philips offer this type of mask (link to F30i from ResMed or Dreamwear Full Face from Philips)

Choosing the correct type of mask is a crucial part of sleep apnea therapy. Selecting the wrong mask can not only lead to an uncomfortable sleep experience but also adversely impact on the effectiveness of the treatment. An ill-fitting mask can allow air to leak out which, in turn, increases the air pressure being delivered thus defeating the efficacy of the treatment..

Simply the Best

APAP treatment is not suitable for everyone which is why it is important to have an assessment done by a qualified sleep expert or doctor.

Although there are other treatments available for treating OSA, sleep experts and specialists are of the opinion that APAP therapy is simply the best. It is true that the devices can take time to get used to but the benefits can be felt within just days of beginning treatment.

The first night will obviously be the most difficult with patients finding minor issues if not properly fitted such as:

  • Uncomfortable feeling of restriction from the mask
  • Dry or sore mouth in the morning that heated humidification resolves
  • Nasal congestion, mild sinusitis or a runny nose
  • Skin irritation around the mask

These are common issues which usually resolve themselves in a matter of days and a small price to pay for better quality sleep, a good night's rest and an improved sense of well-being that only a fully refreshed body can enjoy!