Living with OSA
Being diagnosed with a new condition can sometimes be a confusing experience. By knowing as much as you can about the condition and its treatment you can help to alleviate this confusion and ensure you have made the right choices along the way. This link is designed to help OSA sufferers and their families better understand the procedures that will happen after diagnosis, what to look for when choosing equipment and how to live with the treatment.
Visiting the Physician
If your first night in the sleep lab was a full night of diagnosis you may be booked in for another night in the sleep lab. The purpose of this second night is to initiate CPAP treatment and find the exact pressure that maintains an open airway for you. This process of finding your therapeutic pressure is called a "CPAP titration". Depending on your physician and their protocols you may be issued with a temporary CPAP at home to adjust to prior to your titration study or alternatively the night of your CPAP titration study could be your first experience with CPAP (as outlined in Patient Information series 1 as a split-night study).
Once your titration pressure has been established your physician will meet with you, discuss your CPAP study and write a CPAP prescription with titration pressure (anything between 4-20 cmH2
Your physician will then refer you to a homecare equipment provider that you can purchase your equipment from. The homecare provider will also educate you on the importance of using your treatment every night and how to fit and clean the equipment.
Things to consider when purchasing your equipment
CPAP treatment needs to be used every time you sleep in order to experience the benefits. For this reason it is important to optimize the comfort of the treatment by having the best fitting mask, the most appropriate machine for your demands and any additional equipment that might enhance the treatment or help you to use it for the entire night without adverse effects.
Today there are a number of different CPAP machines and masks on the market. Although this might make the choice difficult, it means that there will be something for almost everyone.
1. Heated humidification
A heated humidifier consists a unit with a water chamber that sits on a heater plate. The heater plate has a temperature control that the user can turn up or down as required. The purpose of this equipment is to warm and moisten the CPAP air before it is delivered to the user. By warming and moistening the CPAP flow to the nose or mouth you can prevent nasal congestion or a dry mouth/throat that can develop from the dry CPAP flow. Research has repeatedly shown that by using heated humidification with CPAP treatment people report less incidence of nasal side effects. Research has also shown that people using a heated humidifier use their machines for longer each night compared to those that don't use heated humidity. Some CPAPs come with a humidifier integrated for compactness and ease of use. (For more information see Heated Humidification
2. Choosing the right mask
There is an extensive array of CPAP masks available on the market today. The three basic mask types are a nasal (nose) mask, an oral (mouth) mask or an oral-nasal (full-face) mask. The mask type you choose should depend on what you feel most comfortable with, regards the fitting, the design, the comfort and the breathing route (mouth, nose or both). Some of the most commonly reported side effects from CPAP masks include:
Mask leaks (develop with head movement on the pillow)
Nasal congestion/dryness (caused by the dry CPAP air)
Skin abrasions (on bridge of nose/back of neck from mask pressure/headgear rubbing)
Forehead dents/marks (from pressure of mask)
Dry mouth/throat (caused by mouth leak which can develop from nasal congestion)
To help prevent the development of some of these side effects choose your mask carefully. Manufacturers are constantly improving mask designs to provide a better fit. Research has shown that by optimizing mask comfort people will use their machines for longer at night due to less side effects from the mask.
3. Helpful hints on mask choice:
Overall things to consider
Choosing a mask on the basis of how you naturally breathe will aid a more natural transition to therapy. If you breathe through your nose AND mouth a full-face mask will allow mixed delivery as your breathing patterns change through the night. If you have nasal obstruction and find breathing through your nose difficult, an oral or full-face mask is the best option.
If you feel claustrophobic a mask that provides a free field of vision may suit you better such as a direct nasal mask.
If you would prefer the freedom of little or no headgear a direct nasal or oral mask may suit you best.
Try taking the mask apart and putting it back together. People may find some masks more difficult to assemble than others.
In summary, when purchasing your equipment you might want to consider the following things:
Remaining on Therapy
Do I want/need heated humidification?
Is the machine quiet?
Do I want a compact unit for travel?
Is the CPAP compatible with DC supply should I wish to go camping?
Does the unit have switch mode power supply (for use in different countries?)
What extra technology is on offer and will I benefit from it?
How do I breathe? Do I want a nasal mask, direct nasal mask, full-face mask or an oral mask?
Is the mask comfortable?
Is the mask easy to assemble?
OSA is a condition that affects people EVERY time they sleep. For this reason it is important to use the treatment every time you sleep. CPAP treatment should not significantly interfere with your lifestyle but become part of it. Most CPAP systems are compact and fully portable for your convenience.
More importantly your CPAP mask or interface should fit snug and seal appropriately. The headgear, mask and cushion require regular washing to prolong their life and prevent infection. The mask should be replaced at least once a year to achieve the best comfort and hygiene. Depending on your insurance policy and the country you reside in, insurance may cover the replacement costs of your consumables (mask, tubing, chambers). Contact your homecare provider for a relevant replacement schedule.
Support Groups and Living with OSA
OSA support groups have been set up around the community in order to help sufferers and their families live with this disorder. For details of a support group in your area contact your local sleep lab or sleep specialist.