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Sunday, January 20, 2013

CPAP for Sleep Apnea: Is it Worth It?

Obstructive sleep apnea (OSA) is a disorder in which a person does not breathe for periods of time while sleeping due to the presence of an upper airway obstruction. It is believed that one in five American adults have at least a mild sleep apnea. It is common in people who are obese. There are numerous treatment options for OSA, one of the most common of which is CPAP.

CPAP stands for continuous positive airway pressure. It involves placing a mask over the face that blows pressurized air into the airway to keep it open. The mask is attached to a tube and machine.

Typically, sleep studies can provide objective evidence that CPAP is beneficial to the individual by studying them on certain parameters (e.g., oxygen saturation levels) with and without CPAP. Although CPAP can be beneficial, there can be many disadvantages to using the device as described below.

Recently, researchers conducted a study to evaluate the experiences of 15 obese CPAP users via semi-structured interview. The researchers found three common experiences. One theme was being restricted in everyday life. This included consequences on social life (e.g., disruption of bed partners, embarrassment when traveling, difficulty bringing it when travelling, and marks on the face that remained the next day (also causing embarrassment). There were also difficulties noted maintaining some bed routines (e.g., reading in bed before falling asleep).

A second them was coming to terms with wearing CPAP. This was largely due to physical discomfort such as difficulty fitting the mask on, a dry nose sometimes leading to nose bleeds, difficulty using it during a cold, discomfort from the mask or straps, and air leakage. Coming to terms with using CPAP also had to do with difficulties caring for the equipment, getting used to using it, learning how to use it, dealing with the noise of the machine, adhering to use of it each night, and spousal disruption/acceptance. Only 1 of the 15 people interviewed got used to using the machine quickly. However, despite the initial difficulties, participants eventually integrated CPAP into their lives and felt it was worth the trouble.

A third theme was that despite the problems noted above, using CPAP helped the participants get a new life. Specifically, they reported sleeping better, feeling more alert, and having more energy to do things, improved social life, and an improved sense of well-being. The authors noted that incentives were important to support the use of CPAP due to the many disadvantages in brings.

Suggested reading: Sleep Apnea and CPAP - A User's Manual By a User
 
Reference: Willman, M., et al. (2012). Experiences with CPAP treatment in patients with obstructive sleep apnea syndrome and obesity. Advances in Physiotherapy, 14: 166–174

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