CPAP information

Overview of Obstructive Sleep Apnoea (OSA)

Obstructive sleep apnoea (OSA) is a sleep-disorder characterised by repetitive episodes of partial or complete blockage of your airway. During wakefulness, muscles keep the airway open to allow us to breathe. These muscles relax during sleep and the airway narrows. Snoring occurs when structures in the airway vibrate as the air we breathe passes in and out. Obstructive sleep apnoea occurs when the relaxed airway becomes so narrow that breathing becomes partially or completely blocked.

It is important to treat obstructive sleep apnoea for many reasons. One of the consequences of OSA is excessive daytime tiredness, which can have detrimental effects on work, performance, memory, learning, social and personal life, and safety when driving or operating machinery. OSA also has detrimental effects on health, and is associated with obesity, high blood pressure, heart disease, stroke, diabetes, depression, mood disorders, insomnia, impotence and loss of libido.

The negative consequences of sleep apnoea can be reversed when correctly treated.

CPAP Treatment for OSA

There are many different treatments available for snoring and obstructive sleep apnoea. Depending on the severity of your sleep apnoea and others factors, you may require a treatment called Continuous Positive Airway Pressure (CPAP, pronounced 'see-pap'). Things which your Sleep Physician will take into account when recommending CPAP may include:

  • body weight, fitness and amount of regular physical activity you achieve
  • amount and frequency of alcohol-consumption
  • whether you are a cigarette smoker
  • medications, especially sedatives
  • the anatomy of your airway and neck circumference
  • whether you have had your tonsils surgically removed
  • whether your breathing is affected (such as if you have nasal congestion or other airway-related problems)
  • other medical conditions you may have, such as heart or lung disease
  • occupation (especially drivers and people who are required to operate heavy machinery or work in dangerous situations)
  • How disruptive your snoring is to others (such as if you and your partner have to sleep separately because of your snoring and obstructive sleep apnoea).

CPAP therapy is now considered to be the most effective treatment for obstructive sleep apnoea.

How CPAP treatment works

CPAP treatment uses a positive air pressure to hold the airway open during sleep. The positive air pressure is generated by a pump called a CPAP machine, and is applied through a small mask which fits over the nose, or the nose and mouth. CPAP stops snoring by preventing structures in the airway from vibrating. Equally as important, CPAP prevents the airway from becoming narrow and obstructing breathing. When an optimal pressure is applied through the mask, your breathing becomes regular and unobstructed, your body's oxygen levels remain stable, you do not snore, and there are fewer disruptions to the rhythm of your brain-waves.

The CPAP machine does not breathe for you and not supply you with extra oxygen. Instead, CPAP maintains an open airway to allow your body to breathe normally.

Unfortunately, CPAP cannot cure obstructive sleep apnoea - it only treats the symptoms of OSA. Therefore, if you cease using CPAP, your snoring and obstructive sleep apnoea will return. For this reason, CPAP treatment must be used every night.

Before Starting CPAP You Need to Know if You Have OSA

The first step to treating suspected sleep apnoea is having a correct diagnosis. An overnight diagnostic sleep study (called an overnight polysomnogram) is the best way to assess obstructive sleep apnoea. Depending on the results of your sleep study, your Sleep Physician may recommend a CPAP-titration study.

A CPAP-titration study is a sleep-study where you trial a CPAP machine and mask. While you are asleep, the pressure applied to the mask is slowly increased and decreased to find the pressure which is most optimal for you - that is, the minimum pressure which stops you from snoring, prevents you from not breathing, and allows you to have the most restful sleep.

Improvement in Snoring and OSA Symptoms

Your snoring will cease as soon as you are treated with CPAP at your optimal pressure. Some people experience improvement in the severity of their daytime tiredness and symptoms immediately after starting CPAP, while some people take a little longer to adjust and notice improvement.

The Side Effects

CPAP treatment has been used world-wide for over 20 years and is very safe.

Some people initially experience minor symptoms of discomfort associated with the use of CPAP masks and equipment, however these generally resolve after a week or two.

Other side effects which may occur with CPAP include:

  • Dry mouth or nasal passages
  • Skin irritation or rash where the CPAP mask contacts the face
  • Sensation of air pressure through the mask being too high, and
  • In some rare cases, reflux or sensation of abdominal bloating.

Many people will experience none of these symptoms and very few people will experience them at all. With specialist advice from your Sleep Physician and ur CPAP equipment-supplier, all of these symptoms can be overcome to make CPAP treatment pleasant and effective.

CPAP Tolerance

CPAP is a treatment like any other in that it may take time to adjust to, and therefore requires commitment. CPAP may be slightly more difficult if you suffer from claustrophobia. Your Sleep Physician and CPAP equipment supplier can inform you of ways to help overcome these problems. Information on CPAP familiarisation can also be found here.

In The Long Term

CPAP treatment is often long-term, and while your obstructive sleep apnoea is present, CPAP treatment will most likely need to be continued. However, there are several ways to reduce the severity of your obstructive sleep apnoea, including:

  • Reducing body weight
  • Reducing nocturnal alcohol-consumption and sedating medications
  • Learning to sleep exclusively on your side all of the time
  • Learning good sleep habits
  • Ceasing cigarette smoking.

Often, the severity of an individual's sleep apnoea can be reduced greatly by taking these measures, sometimes to the point where CPAP treatment is no longer required. Even if CPAP therapy cannot be withdrawn, the required pressure can often be reduced to improve comfort and tolerance.

Other Treatments for Sleep Apnoea

While CPAP is the most effective treatment for obstructive sleep apnoea, it is not the only one available. There are a variety of of other treatments which you can discuss with your Sleep Physician or treating practitioner, which may be prescribed instead of, or in addition to, using CPAP.

Obtaining a CPAP Mask and Machine

Your Sleep Physician will be able to advise you of how to go about hiring or purchasing a CPAP machine and related equipment. If you are unable to afford your own CPAP machine, you may be eligible to obtain a machine through the Queensland Health CPAP Machine Scheme. Information on this scheme is also available from your Sleep Physician.

Reassessing Your CPAP Treatment

Your CPAP treatment requirements change over time, especially if you lose or gain body weight, change the amount of alcohol you regularly drink, cease cigarette smoking or undergo any other medical treatments or procedures. SNORE Australia recommends that if any of the above changes occur or you have any reoccurance of previous symptoms, you should be reassessed. This ensures that your CPAP treatment is optimal.

Other Types of Positive Airway Pressure

Some patients with obstructive sleep apnoea or other sleep-related breathing disorders may require different types of positive airway pressure treatment.

  • Bi-Level Positive Air Pressure (BPAP) machines have a different pressure setting during inspiration (breathing in) compared to expiration (breathing out). BPAP is sometimes necessary for patients with very severe sleep apnoea and/or patients having difficulties tolerating high CPAP pressures.
  • Automated Positive Air Pressure (APAP) machines have an inbuilt computer which tries to calculate how much pressure you need at any given moment, and alters the pressure accordingly. APAP is often helpful in people who have difficulties with CPAP, or whose CPAP pressure changes from night-to-night (for example, with high levels of alcohol consumption).

Where to Obtain CPAP Advice

Information on CPAP masks and equipment can be obtained from a variety of providers.  SNORE Australia's preferred supplier is Air Liquide Healthcare, which operate CPAP clinics from many of our premises.  Air Liquide Healthcare provides an extensive range of competitively-priced CPAP equipment and masks, as well as a 'Hire-to-Buy" option and favourable arrangements for patients who need to change masks after an initial trial.  Some of these arrangements are exclusive to patients of SNORE Australia. 

Click here to visit the Air Liquide Healthcare website. 

Air Liquide Healthcare