Treatment Options

Nasal CPAP for Treatment of Obstructive Sleep Apnea (OSA)

Significant Value

OSA occurs when the throat becomes blocked during sleep. This blockage causes the airway to collapse and prevents the lungs from getting enough air. Individuals with OSA stop breathing for 10 seconds or more at a time. This can occur up to several hundred times every night due to repeated collapse of the airway. Symptoms of OSA include: snoring, tiredness, sleepiness, memory and judgment problems, irritability, difficulty concentrating and personality changes. A sleep study is used to diagnose OSA.

CPAP is used for the treatment of OSA. A CPAP device is about the size of a shoebox and sits beside the bed. It consists of an air blower (airflow generator) attached to flexible tubing leading to a face mask (that fits over the nose or over the nose and mouth) or nasal prongs. It uses air pressure to push the tongue forward and open the throat, allowing air to pass through the throat. The airway pressure delivered into the throat is continuous during both inhaling and exhaling. The air pressure is adjusted so that it is just enough to prevent the throat from collapsing during sleep.

Many individuals (some estimates are as high as 50percent) have difficulty tolerating the use of CPAP. Ways to encourage the use of CPAP include: treatment of nasal symptoms; trying several masks to find the most comfortable fit; humidification of air; providing close follow-up and encouragement.

CPAP is not a cure for OSA and must be used every night. CPAP should also be used when taking a nap. Nonuse of the CPAP device leads to a full return of OSA symptoms.

Things to Consider

  • More than 20 million Americans, approximately 1 in 4 men and 1 in 10 women, are estimated to have some degree of OSA. Individuals currently undergoing treatment for OSA are probably less than 500,000.
  • OSA is more common among the obese and in males.
  • CPAP is considered the most effective noninvasive treatment for OSA.
  • CPAP is a physician prescribed treatment for OSA to be used while sleeping.

Results

Significant Value

Will I live longer if I use CPAP?

The use of CPAP may lengthen your life by decreasing stress on the cardiovascular system (by lowering blood pressure) and respiratory system (by maintaining adequate airflow).

Will use of CPAP improve my quality of life?

Yes. Symptoms of OSA will be decreased / eliminated while using CPAP.

Safety

Significant Value

CPAP is safe. It is a noninvasive and nonsurgical treatment.

Potential benefits:

  • Daytime sleepiness decreases
  • Heart function and hypertension improve
  • Quality of life improves as symptoms decrease
  • Survival rates may increase, according to some studies

Potential side effects:

  • Sensation of suffocation / claustrophobia
  • Inability to sleep
  • Nasal congestion
  • Pressure on the face
  • Sore or dry throat
  • Headaches
  • Nosebleed
  • Mask-related problems such as rash, skin abrasions, and eye irritation (from air leakage)

Comparison

Significant Value

Alternative treatments include:

  • Surgical procedures (invasive, not uniformly effective, and carry risk)
  • Pharmacological treatment (none indicated in the routine treatment of OSA)
  • Oxygen (not a satisfactory treatment option by itself because it does not reduce sleep disruption and subsequent daytime sleepiness)
  • Weight loss (may improve symptoms of OSA)
  • Avoidance of sedatives and alcohol (may improve symptoms of OSA)

CPAP is considered the most consistently effective treatment for OSA.

Cost

Significant Value

The cost for CPAP treatment may range from $5,000 to $24,000 or more per year.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

Mayo Clinic. (2012, July). Obstructive sleep apnea. Retrieved March 25, 2014 from http://www.mayoclinic.org/diseases-conditions/sleep-apnea/basics/definition/con-20020286.

Mayo Clinic. (2011, November). CPAP machines: Tips for avoiding 10 common problems. Retrieved March 25, 2014 from http://www.mayoclinic.org/diseases-conditions/sleep-apnea/in-depth/cpap/art-20044164.

National Institutes of Health. (2014, February). NINDS sleep apnea information page. Retrieved March 25, 2015 from http://www.ninds.nih.gov/disorders/sleep_apnea/sleep_apnea.htm.

WebMD (2012, January). Continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea. Retrieved March 25, 2015 from http://www.webmd.com/sleep-disorders/sleep-apnea/continuous-positive-airway-pressure-cpap-for-obstructive-sleep-apnea.

Next Review Date

3/27/2015

This document has been classified as public information.

Table of Findings

results:  significant value

safety:  significant value

comparison:  significant value

cost: significant value


total: significant value

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Page modified:March 31, 2014