Your doctor has told you that you need to use a Continuous Positive Airway Pressure (CPAP) machine while you’re sleeping to treat your obstructive sleep apnea. If you’re like most people who receive this news, you’ve got mixed feelings about it.
"Most people are not thrilled," says Meir Kryger, MD, director of sleep medicine research and education at Gaylord Hospital in Wallingford, Conn., and a researcher for Respironics and ResMed, which develop and manufacture sleep apnea devices. "Some are relieved there is a treatment for what they have."
Sleep apnea is marked by brief but repeated interruptions in breathing during sleep. The CPAP typically includes a face or nasal mask that pumps a flow of air into the nasal passages to keep the airway open. But some people abandon the machine before they can get used to it. In a study of 639 people published in 2010, 19% had stopped using the machine after four years and 30% had stopped within 10 years.
But adjusting to CPAP can make your sleep -- and life – better, especially if you have severe sleep apnea. Read on to get sleep specialists’ top five tips on how you can make peace with the device.
Focus on the Health Benefits of CPAP
To help people stay focused on the big picture, Nancy Collop, MD, president-elect of the American Academy of Sleep Medicine and professor of medicine at Emory University School of Medicine, explains what is happening in your body.
"Your body is in this constant struggle at night between breathing and sleeping," says Collop, who also directs the university sleep center. "Fortunately, breathing wins, but it wins at the expense of your sleep."
Lack of sleep causes daytime sleepiness, which can make it difficult to function at work and elsewhere. But lost sleep can also have an adverse effect on aging, diabetes, and blood pressure.
The purpose of the CPAP is to take away the struggle between breathing and sleep. And the majority of CPAP users report immediate symptom relief, according to the National Sleep Foundation. They also report increased energy and better mental alertness during the day.
"Very few people like CPAP, but they love the outcome," Kryger tells WebMD. Kryger says that using CPAP improves heart rhythms in some people. (Abnormal heart rhythms can increase the risk of stroke.) CPAP use may also reduce high blood pressure, at least a little.
Many people also feel that using CPAP makes them less of a danger to themselves and others – when driving, for example, or operating machinery. "In terms of safety issues, they are not going to be a hazard due to daytime sleepiness," Kryger says.
Consider CPAP a Gift to Your Bed Partner
Often, the bed partner of someone with obstructive sleep apnea has a sleep problem too -- brought on by the constant awakenings and snoring of the person with apnea. The interruptions can be bad enough to drive the partner from the bedroom altogether, some research suggests. So Kryger tells people the treatment will likely improve their lives and the lives of those they love.
In return for the gift of better sleep, you might ask your partner not to pressure you about using the device. In a study published in Sleep and Breathing, researchers found that people whose spouses pressured them to use the CPAP actually used it less often.
Learn All You Can About the CPAP
It's not enough for you to be handed a mask, machine, and instruction book, Kryger says. Ideally, a representative from the company providing the device should deliver it and demonstrate it.
Numerous manufacturers offer CPAP machines, so it's a consumer's market. Ask your doctor to request a representative and a demonstration when he writes the order for the machine. You can also take advantage of the manufacturers’ 800 numbers.
When the CPAP device is delivered, you and the representative can double-check that the machine and the mask are exactly what were ordered. With so many models and varieties, Kryger says, it's crucial to be sure you got what the doctor ordered.
You should learn what pressure is recommended for you and other basic facts about the machine. The representative should also be able to answer any questions you have or to get answers for you.
Customize the System for You
CPAP machines are not one-size-fits-all. These tips can help you ensure your device is the right one for you:
- Talk to your doctor about the best CPAP model for you. The premise of CPAP machines hasn't changed since they were introduced more than 25 years ago, Collop tells WebMD. "What's changed are the size of the machines and the loudness," she says. "The new machines are smaller than a shoe box. They are much quieter. Almost all the machines now have the capability of humidifying the air." Depending on the climate where you live, this may be an important feature for you. Ask your doctor about the different features that are available.
- Get a CPAP mask that fits well. People often say they’ve given up on their device because it’s uncomfortable. However, that can typically be remedied by getting a different mask or other measures, according to sleep specialists. There are a wide variety of masks available. Kryger tells patients, "Make sure you have a comfortable mask."
- If your CPAP machine seems outdated, try to upgrade. Typically, the devices are covered by insurance, Kryger says.
- Tell your doctor about any symptoms you experience. If symptoms -- such as snoring -- that initially went away on CPAP start reappearing while using the device, get reevaluated, Kryger says. In about half of CPAP users, other side effects can occur -- such as nasal congestion, dry mouth, or skin irritation. Talk to your doctor to remedy these problems and make sure the machine is working as you need it to.
Stick With It
"It's not a cure," Collop tells her patients. "It's just a treatment. It only works if you wear it."
What's the harm if people miss a night or two -- say, if they’re on the road? "Whenever you sleep without it, you still have sleep apnea," she says. "If they miss a night or two, life will go on, but they will notice a difference."
If you make the effort to adjust to the CPAP device and wear it regularly, however, the payoff is big: "CPAP works for almost everybody," Collop says.
Not everyone with obstructive sleep apnea needs CPAP. If the condition is mild, other treatments may help. But if your apnea has progressed beyond a mild condition, CPAP can help give you back your sleep and improve the quality of your life.