the trouble with CPapsWhen a sleep apnea diagnosis is given, chances are the patient will be advised to begin using a CPAP machine every night while sleeping. CPAP, or continuous positive airway pressure, is a commonly prescribed treatment for the episodes of interrupted breathing present in sleep apnea. The CPAP machine is a medical device that runs on electricity. It is placed next to the bed on a nightstand or table. There are three parts to a CPAP machine: a pump housed in a box about the size of a clock-radio; a long section of plastic hose or tubing; and a face mask designed to strap onto the patient’s head, covering his nose and mouth. 

The CPAP machine works by taking in air and pressurizing it. The pressurized-air then blows through a tube and mask into the patient’s throat. The pressure of the air keeps the patient’s throat open while he is sleeping. CPAP can be successful in treating sleep apnea when used correctly; however, there are many obstacles that lead to non-compliance among users and challenge the level of success.

  • Patients with varying levels of claustrophobia, an anxiety-provoking feeling of being trapped or confined, report discomfort when using CPAP machines. For those patients, fitting a mask over the face can cause agitation or even panic, making it nearly impossible for them to relax and fall asleep.
  • The CPAP mask is attached to a bulky plastic corrugated hose that connects to a larger pump device. As the patient moves during sleep, the hose can become entangled in bedding, around the patient’s arms or even around her neck. The resulting discomfort prevents deeper stages of restful sleep.
  • Sometimes the unnatural movement of forced air into the mouth and throat is enough to prevent sleep. Patients can have a hard time adjusting to the feeling. Some never get used to it and fail to comply with the requirements of CPAP treatment.
  • Some CPAP users complain of allergy-like symptoms during use. Dry and itchy eyes, dry mouth, and congestion have been reported.
  • An ill-fitting mask can leave temporary tell-tale indentations on the face that make some users feel embarrassed or self-conscious. Left untreated, the nightly pressure on the skin from a too-tight mask can lead to uncomfortable irritation and skin abrasions.
  • On the flip-side of a too-tight mask, CPAP masks can also become loose and fall off during sleep or be pulled off by the user while he or she is asleep. The success of therapy is thwarted when masks malfunction.
  • CPAP users also report some environmental-related discomfort. During warmer weather, some patients complain of feeling hot and/or sweaty. Conversely, during colder winter months, users report that the mask feels cold and causes chills, making it hard to get a good night’s rest. The mask is inherently moist and some patients can’t deal with the feeling of wetness on their face from the device.
  • Those who travel frequently are less likely to comply with the rigors of treatment. Some find the equipment bulky and too inconvenient to pack and unpack every time they travel. They prefer not to have to set up equipment in hotel rooms or vacation homes.
  • Some simply feel too unattractive while wearing the apparatus, so refuse to continue with treatment.

These are just some of the reported drawbacks to CPAP use and compliance. Fortunately, there are alternatives to CPAP available including oral devices custom fit to individual patients and surgical solutions that eliminate the need for bulky medical device intervention. Future blog posts will provide more detail about sleep apnea treatment options provided at Maxillofacial Surgery Center for Excellence.

picture crop What is Sleep Apnea? Kayvon Haghighi, DDS, MD, FACS is licensed to practice both medicine and dentistry in the state of New Jersey. Dr. Haghighi’s unique combination of surgical training and experience in facial reconstruction enables him to analyze your condition from multiple points of view.