Sleeping with a mask over your face might not be the most pleasant thing to curl up with at night. But if you have severe sleep apnea, a therapeutic device might be just what you need to get a good night of quiet, restful sleep.
What is positive airway pressure?
The most widely-used, current therapeutic used to treat sleep apnea is positive airway pressure, whereby a breathing machine pumps a control stream of air through a mask that you wear over your nose, and mouth, or both. This additional pressure slants or holes open the relaxed muscles, just as air in a balloon inflates it. There are several different versions of this positive airway therapy.
CPAP or continuous positive airway pressure. In this therapy, a controlled air compressor generates an airstream at a constant pressure. This pressure is prescribed by your physician, based on an overnight test or titration. There are newer CPAP models available which slightly reduced the pressure when you exhale to increase your comfort and compliance.
VTAP or variable positive airway pressure, which is sometimes called by level or BiPAP, uses an electronic circuit to monitor your breathing. It actually provides two different pressures, a higher one during inhalation and a lower pressure during exultation. This system is more expensive than a CPAP system and is sometimes used with patients who have other respiratory problems or who find that breathing out against an increased pressure is uncomfortable or disruptive to their sleep.
The newest form of these therapies
APAP or automatic positive airway pressure is the newest form of these therapies. An APAP machine incorporates pressure sensors and a computer which continuously monitors your breathing performance. It adjusts pressure continuously, increasing it when you are attempting to breathe but cannot, and decreasing it when the pressure is higher than necessary.
Although FDA approved, these devices are still considered somewhat experimental by some people and are not covered by most insurance plans.
Finally, there is a second type of physical intervention called a mandibular advancement splint (MAS) that is sometimes prescribed for those who have mild or moderate sleep apnea. This device is a mouth guard similar to those used in sports to protect the teeth. In the case of apnea patients, the device is designed to hold the lower jaw slightly down and forward relative to the natural, relaxed position. This holds the tongue further away from the back of the airway, and may be enough to relieve apnea or improve breathing.
The FDA accepts only 16 oral appliances for the treatment of sleep apnea.This oral appliance therapy is less effective than CPAP, but is more "user-friendly."In addition, there are drugs that are sometimes prescribed to treat the patient's daytime sleepiness.
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