Here are the best ways to get the treatment you need…
If you’ve got obstructive sleep apnea (OSA)—that well-known sleep disorder marked by snoring and gasping—you’ve no doubt been told that it’s a serious condition. It can lead to high blood pressure, heart disease and stroke, along with severe fatigue and night after night of disrupted sleep.
In case that all sounds pretty frightening, don’t lose hope. OSA can be virtually eliminated with a nondrug treatment. The problem is, about half of all patients stop using the treatment within the first year. Some last only a few nights.
Why do so many people give up on a treatment that works so well? Because they hate it!
However, there are ways to make “CPAP”—the nickname of this treatment—much more tolerable so that you can finally get the pleasant sleep you need and deserve.
Here’s how to make CPAP a much better experience…
TREATMENT THAT WORKS
The gold standard treatment for sleep apnea is continuous positive airway pressure (CPAP). With this therapy, a machine about the size of a shoe box delivers a constant flow of air that opens your airways and improves your breathing.
Unfortunately, CPAP machine users are tethered to the machine all night, and some of these machines are noisy. You also have to wear a mask over your mouth and/or nose, which makes some people claustrophobic. And the flow of air can cause uncomfortable mouth/nose dryness and eye irritation.
Startling study: Only 46% of patients prescribed CPAP used the devices for more than four hours a night on 70% of all nights—the threshold for effective treatment.
Because proper use of CPAP can reduce health risks associated with sleep apnea to close to zero, this is not a treatment that you want to give up if you have this condition.
MAKING PEACE WITH CPAP
If you’re prescribed CPAP therapy, you may want to start out with a basic machine just to see how well you respond. Ask your respiratory therapist about renting a machine to try it out first. This device might do a good job of improving your symptoms, and the purchase price is usually $500 or less, compared with pricier, more sophisticated units (see below).
But what if you find the machine to be so uncomfortable that you stop using it? You have a lot of options. A sleep specialist or respiratory therapist can help you sort them out. CPAP machines are usually covered by insurance. Where to start…
• Different masks. A full-face style that covers the mouth and nose provides a good fit and is more likely than other masks to stay put during the night. A total face mask extends all the way from the forehead to the chin. But you’ll look like Darth Vader and might, ironically, feel like you’re suffocating.
You may prefer a nasal “pillow,” an under-the-nose mask with nostril tubes that’s less obtrusive and won’t obscure your vision if you like to read before falling asleep.
A nasal mask that fits only over the nose is yet another choice. It’s more likely than the nasal pillow to stay in place. Many people find this more comfortable than a full-face configuration. Prices for the masks described above generally range from $40 to $200 (in addition to the cost of a CPAP machine).
• A “ramp” feature. Most CPAP machines, starting at around $500, have a feature that gradually ramps up air pressure so that the full force won’t be felt right away. The machine can be programmed to automatically raise pressure every five minutes or so until the prescribed amount is reached—and you have fallen asleep.
• Heated humidification. This is now a standard feature on many units. Everyone who uses CPAP occasionally suffers from nose or mouth dryness. The humidity added by certain machines reduces this effect and makes you more comfortable. You need to fill and clean a water tank with these models. They are available at all price levels, from less than $500 to more than $1,500. Also helpful: A squirt of saline solution into each nostril before you put on any CPAP mask. Doing this will help prevent dryness and nighttime congestion.
• Bilevel PAP. Unlike the continuous pressure in some machines, bilevel PAP (also known as BiPAP) units match the airflow to your breathing. They increase pressure during inhalations—when apneas (breathing cessations) usually occur—and decrease it when you exhale. Research has shown that people with bilevel PAP machines are more likely to keep using them than those with non-bilevel PAP units. Prices start at about $600.
• AutoPAP. These machines are a bit different from bilevel PAP machines because they automatically change air pressure on a breath-by-breath basis. When you sleep on your back, for example, you will naturally tend to have more apneas. The machine will detect breathing changes and make the necessary adjustments in air pressure. Prices start at around $400.
“NO MORE CPAP!”
Some people never get comfortable using CPAP of any kind. For these individuals—especially if they have milder OSA—other options include…
• Oral appliance. This custom-made mouthpiece helps keep the airway open and is especially effective for people who sleep on their backs. The $2,000 cost may be covered by insurance.
• Nasal valves. When you go to bed, you apply a small, Band-Aid–like strip over each nasal opening. The strips have nasal plugs with small valves. The valves open when you inhale, then partially close when you breathe out. This creates expiratory positive airway pressure that helps keep the airways open.
Example: Provent Sleep Apnea Therapy. This FDA-approved sleep apnea treatment requires a prescription and costs about $70 a month, which might not be covered by insurance. It may not be suitable for people with chronic health conditions such as heart disease.
• Winx Sleep Therapy System. This consists of a small, flexible mouthpiece and a plastic line that connects to a console. This system creates oral airway pressure, similar to CPAP units. But it doesn’t require a mask and is
more tolerable for some people. It costs about $700. Winx received FDA approval in 2012, and some insurers may cover it. It should not be used by anyone with a severe respiratory disorder, loose teeth or periodontal disease.