Obstructive Sleep Apnea Ebook (PDF)




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Title: CPAP, APAP, BiPAP, and ASV Therapies : Costs, Problems, and Options

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CPAP, APAP, BiPAP, and ASV
Therapies : Costs, Problems,
and Options
An introduction to the different types of PAP therapy for Sleep
Disordered Breathing.

Table of Contents
1.

How does a CPAP machine work?

2.

Using Auto-CPAP (APAP) Therapy

3.

FAST FACTS: The difference between APAP and CPAP

4.

When is BiPAP therapy the best treatment?

5.

Adaptive Servo Ventilation (ASV) and Central Sleep
Apnea

6.

5 things you need to know: Central Apnea & ASV
therapy

7.

Traveling with a CPAP Machine: Tips, Tricks, and
Options

8.

Where to buy CPAP supplies (DME, online, or retail?)

9.

How Much Does a CPAP, APAP, BiPAP Machine Cost?

10. Does Insurance Pay for a CPAP Machine? (Coverage
and Cost)

11. "How do I clean my CPAP?"
12. Need Help with CPAP?

How does a CPAP machine
work?

Obstructive sleep apnea (OSA) is a sleep disorder of breathing mechanics.
In order to treat it, the simplest, and most effective, solution is to use a mechanical
therapy that falls under the category of positive airway pressure (PAP).
CPAP, APAP, BiPAP, and ASV are all versions of this kind of therapy.
How these different PAP treatments work relates to how sleep apnea occurs in the
first place. Let's review what sleep apnea is, how a PAP machine operates, and how
the mechanisms of this therapy treat OSA.

Sleep apnea 101

At night as you sleep, your brain switches to an automated system that allows you
to breathe once you are unconscious. However, if your body experiences obstacles
to breathing as you sleep, it will wake itself up so that you can consciously take a
breath to remove these obstacles.

What is sleep apnea?
An apnea is a pause in breathing that lasts more than

10 seconds and which leads to an unhealthy drop in blood oxygen. Sleep apnea, as

the name suggests, occurs only as you sleep.
In the case of obstructive sleep apnea (OSA), there is an obstruction in the upper
airway that is blocking the passage of air into or out of your lungs as you sleep.
The body itself may continue to try to breathe, but the obstruction prevents any
oxygen from entering the bloodstream (or any carbon dioxide from being exhaled).
This creates a chemical imbalance in the body which leads to alerts to the brain to
"wake up" to breathe.

What causes these obstructions?

The most common obstructions during an apnea take place in the upper airway at
the back of the throat. The tissue is relaxed here during sleep, which can lead to
problems if the tongue has dropped into the back of the throat, or the airway itself
has been crowded by overlarge tonsils or uvula.

Some people also have very narrow passageways to begin with, and the space
itself is compromised during sleep for this reason.
Those with added fat around their neck , while in a supine position (on the back) are
also vulnerable, as gravity and weight press against the soft, often floppy, tissues
surrounding the airway, creating obstruction.
And any time the tissues of the airway are inflamed or swollen or otherwise
affected (such as congestion, allergies, or asthma), the risks for encountering
obstructive apneas go up.

What is central apnea?
In the case of central sleep apnea (CA), the signals from the brain to the diaphragm
to breathe as you sleep are thwarted, leading to no airflow and no effort to
breathe. Eventually, the same alarms are sounded in the body and the brain sends
you back to consciousness to take a necessary breath to correct the problem. CA is
not a mechanical problem, then, but a neurological one.

CPAP to the rescue
You can think of CPAP as a kind of "pneumatic splint." Positive airway pressure
forces a stream of pressurized air into the back of the throat which helps keep the
airway open and the tissues firm, rather than floppy. When you use CPAP, it's not
actually breathing for you, it's just helping to recreate the proper conditions so that
you can breathe for yourself.

How CPAP machines work
The original CPAP machine was devised using a reversed vacuum cleaner
technology back in the 1980s, believe it or not. The concept still works, though
today's machines are far more sophisticated and comfortable to use.

Here's

how it's done:

Inside the machine is a simple motor which draws air in from the
room, then pressurizes it

Once the "room air" is pressurized, it's sent (usually) through a
humidification chamber, which warms and moisturizes it to make it
more comfortable to the airway

This humidified air is sent by way of a length of tubing to the CPAP
mask to deliver directly to the user through the nose (or, in the case
of full-face masks, through both nose and mouth)

The incoming stream of air pressure opens up the airway and allows
you to breathe independently while asleep, without obstruction

How much pressure is delivered?
Pressurized air is metered by a preset number that has been programmed into the
CPAP machine by a sleep specialist. For many people, the force of the air is gentle,
but effective.
Others with moderate to severe sleep apnea may have higher settings or more
complicated sleep-breathing problems which lend themselves to the use of the
other PAP therapies, such as BiPAP or ASV. The only way to know which therapy
works best for you is through testing and consultation with a sleep specialist.

Bottom line: CPAP saves lives

For millions of people with sleep apnea, PAP has become a lifesaver in this way.
In fact, at sleep centers everywhere, there is a common refrain among long-time
CPAP users: "I won't sleep without it!" CPAP support groups are a great way to
connect with these "super users."
Despite the challenges that some have with adjusting to the therapy, it still remains
the most simple, effective, and noninvasive way to treat sleep apnea.
While some discomfort may temporarily be part of the experience, the long-term
effects of untreated sleep apnea are far worse. Brain damage, hypertension, mood
disorders, sleep deprivation, heart disease, and diabetes are just a few of the
problems you can expect.
Treating sleep apnea is as simple as understanding its mechanical dysfunction and
correcting it using a mechanical therapy. CPAP and its other cousins in the PAP
lineup of therapies are considered the first line of defense against sleep apnea






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