Positive Airway Pressure (CPAP)—the name says it all. This mode literally applies one constant (or continuous) pressure through the circuit and mask interface to be delivered to the patient. Though CPAP is discussed in this chapter as a non-invasive therapy

Despite the highly effective treatment CPAP offers, poor adherence limits its efficacy. Compliance has been variably classified in the literature and thus adherence rates range from 40–85% (1,15). In the US, compliance has been arbitrarily defined as usage for more than 4 hours per night for more than 70% of nights. Of course, this does not correlate to a specific threshold beyond which efficacy is absolute—in short, the greater the use of CPAP, the better the outcomes in terms of symptomatic quality of life markers and longer term blood pressure/cardiovascular readings. Hence, there has been great interest in improving tolerability of the CPAP system. Commonly cited side effects include dermatitis, rhinitis, epistaxis, nasal discomfort, congestion, mask leak, aerophagia, barotrauma and claustrophobia. There may therefore be specific otolaryngological factors contributing to failure of CPAP, particularly in relation to the nasal cavity and paranasal sinuses. Contributing nasal conditions include anatomical, physiological and pathological factors. Anatomical considerations incorporate deviated nasal septum (DNS), external framework deformities, valve collapse, enlarged turbinates and nasopharyngeal pathology occluding the posterior choanae (e.

Wash Your Equipment Properly: It’s important to wash your equipment on a regular basis using warm water and mild soap. To completely stop the growth of germs, some people use a CPAP cleaner device to sanitize their equipment after cleaning.

Nasal mask. This mask will cover your face from the bridge of the nose to the top of your upper lip, creating a seal over your nose but not your mouth. The AAST recommends nasal masks CPAP alternative for people who want a more natural-feeling airflow than they’d get with nasal pillows.

Scientists are still debating whether CPAP therapy can cause voice changes over time. That said, some studies have suggested that using a CPAP machine may cause mild hoarseness in a small number of people. This issue is thought to stem from recurring dryness in the mouth, throat, and airway.

The key finding is that of minimally invasive multilevel surgery as compared to the radical palatal surgeries originally described.

Inspire sleep apnea therapy is an alternate treatment option for people who found CPAP failed to eliminate their OSA, thought it was too uncomfortable, or were unable to use it consistently.

Computed tomography images of two obstructive sleep apnoea (OSA) patients requiring continuous positive airway pressure (CPAP) with nasal pathology. (A,B) Coronal and axial slices of the first patient demonstrating a left sided polyp occluding part of the post nasal space, maxillary sinus disease and a slightly deviated septum to the left; (C,D) coronal and axial images of a second patient demonstrating extensive sinonasal polyposis, which ultimately failed medical management and required endoscopic sinus surgery.

Neither are people who are pregnant or plan to be. In addition, those who have pronounced or unusually large anatomy, such as large tonsils, that prevent upper-airway stimulation may not be eligible.

After a few months of use, patients have a follow-up sleep study to ensure their sleep goals are being met. Once all is confirmed, patients will have check-ins with their sleep physician every seis-12 months at physician discretion.

Between sinus congestion, nose sores, and nasal dryness, CPAP therapy can be tough on your nose, which can worsen any CPAP headaches you may be experiencing. Without treatment, these sinus issues can develop into an infection or cause permanent nose damage.

This splinting effect can be useful for specific lungs issues. It is beneficial in recruiting collapsed alveoli. Involving more alveoli in air exchange will improve ventilation. Another benefit of this “splinting effect” is seen with patients who have symptoms of obstructive sleep apnea.

Therefore, all patients that fail a trial of CPAP should be referred for otolaryngology review to exclude upper airway obstruction and undergo consideration for sitio-specific surgical intervention.

If you’re having difficulty exhaling against your therapy pressure, it may cause an anxious choking episode, making you feel like you are short of breath.