Can you explain the Nasal CPAP system please? I have heard about them and think I many need one for my sleep.

—Jim, Age 53, Naples, FL., USA

Hi Jim—

CPAP stands for Continuous Positive Airway Pressure. A Nasal CPAP device is prescribed by a medical doctor for the treatment of moderate to severe obstructive sleep apnea. If you snore loudly during the night, awaken frequently to use the bathroom, do not awaken from sleep feeling rested, and also are tired throughout the day, you most likely have a significant degree of sleep apnea.

You are right to be seeking advice about a Nasal CPAP device. They truly are miraculous machines—if you are able to use them. At the Sleep Disorders Center of Santa Barbara, CA, when I was Director of the Sleep Apnea Treatment Program, we had a 90% compliance rate with our patients who were prescribed CPAP.

That means nine out of ten patients, after they tried the Nasal CPAP, decided they wanted to keep using it.

The way a nasal CPAP system works is as follows: You wear a mask over your nose while you sleep that’s held on by a headgear, and the mask is soft and makes a snug fit so that no air leaks out. The mask is connected to a tube that is connected to a blower that provides a steady stream of filtered—and usually humidified—air for you to breath.

If you have sleep apnea, it means you are having a difficult time breathing during sleep. The reason why is because our muscle tone relaxes when we fall asleep. When it relaxes, the airway, as it passes through the neck, also can collapse. It either becomes too narrow for sufficient air to reach our lungs, or it closes completely. In either case, you aren’t getting the oxygen you need during sleep. Sleep apnea puts a burden on the heart, is conclusively linked to high blood pressure, and in addition to causing major strokes, it also is suspected of causing small “silent” strokes; strokes that do not cause dramatic loss of motor control, but rather deteriorate memory gradually over time.

The CPAP works by putting positive air pressure into the upper airway. An analogy I like to use when I describe CPAP to patients is that it’s exactly like when you blow air into a balloon; the positive air pressure you blow into the balloon supports the walls of the balloon. When you use the CPAP, and when you wear the mask that has the air blowing into it from the pump, you are putting positive air pressure into your upper airway, which in turn prevents the walls of the airway from collapsing when you fall asleep.

Nasal CPAP devices typically are prescribed after you spend a night in a sleep disorders center, where the severity of your apnea is measured and where the machine is “titrated,” or adjusted, for the particular amount of air pressure you require. When you sleep with a Nasal CPAP device that is properly adjusted for your need, all “disordered breathing events” (periods where you do not get enough oxygen) are eliminated. You maintain a high, stable level of oxygen saturation throughout the night, you eliminate the arousals from sleep that accompany apnea (arousals which cause you to be tired during the day) and you take a load off your heart. And guess what? There’s even a benefit for your bed-partner. You won’t snore anymore!!

Reply

Hi Dream Doctor—

First, a big thanks for the info on CPAP. This is an update on my questions to you.

After a night in a sleep test office it was found that my sleep problems were due to sleep apnea. An average of 50 episodes an hour of going from deep sleep to almost awake caused by the closing of my throat and restriction of the airway.

Last night another night was spent with the CPAP device. After trying several types of masks a gel-filled mask was chosen due to the soft fit with no or little air leakage—and the first of, hopefully, many restful nights began. Due to lab effect a few occurrences of waking up (5) occurred, but otherwise I had a night filled with complete and deep sleep…with NO snoring. My wife can now also enjoy a full night of rest.

We will update you on our future nights of real rest.

—Jim-n-Ellie

P.S. May the rem be with you.