There is no denying that continuous positive airway pressure therapy can impact you over time, usually for the better.
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 quarenta–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.
The Inspire sleep apnea device is surgically implanted into the body, and CPAP treatment is administered through a mask that is worn while sleeping. CPAP equipment requires daily cleaning and regular maintenance.
Before this, severe OSA patients’ only realistic treatment options were CPAP, neurostimulation implants or other invasive surgeries. Today, they have what we believe is a far more desirable option that is very affordable and doesn’t require surgery or a lifetime of nightly use and intervention."
As a corollary to this, it is important to consider repeat DISE following multiple surgeries as the dynamics of the upper airway will have been affected. Another option, in lieu of radiofrequency treatments, remains laser-assisted palatoplasty, which has been shown to reduce pressure requirements and in some cases, remove the need for CPAP entirely (23). Elshaug et al.
This not only demonstrates the potential benefits of surgical intervention for OSA but also highlights the work to be done in redefining outcomes and setting standards for this subset of patients. After surgical intervention it is prudent to repeat the sleep study as part of this ongoing assessment.
Check Out the V-Utilizando: The V-Utilizando is a relatively new product with promising results already! It is designed to make CPAP airflow more comfortable and easier to adjust to, so it’s a great solution for anyone struggling to breathe with their CPAP machine.
Randomized controlled data demonstrate that this treatment can improve OSA, though best results are typically observed in patients with more mild disease. In practice, these devices have experienced limited use as they are difficult for many patients to use, insurance coverage is poor and objective documentation of efficacy is difficult to determine using conventional technology.
Prevent Moisture Loss from Your Tubing: The air produced by your machine may be losing moisture as it moves through your tubing. A heated tube or hose cover can help to prevent the loss of humidity.
If none of those methods work, your doctor might explore surgery as an option. In some cases, it may be beneficial to combine Inspire surgery with Oral Appliance Therapy for better results.
Not only can CPAP be effective, but the machines are now easier to tolerate—quieter and less clunky than older devices. Many newer CPAPs allow you to start the night at a lower air pressure setting—and have that pressure rise gradually after you fall asleep. This can reduce the jarring feeling of air being forced into your nose or mouth.
pressure. The pressure stays the same while the patient breathes in and out. It does not change unless the clinician increases or decreases the set pressure.
Most studies evaluating the effectiveness of positional therapy are based on data from small, uncontrolled studies with relatively short-term follow up. A few observational trials with longer-term follow suggest that compliance with positional therapy over time is poor. Thus, positional therapy using various modalities here should typically be recommended for patients as a secondary or supplemental therapy.
The latest clearance comes less than a year after the FDA granted Vivos 510(k) clearance for the DNA oral appliance to treat mild to moderate OSA.