How Long Do You Have to Use CPAP?

Factors Contributing to Sleep Apnea Determine Long-Term Need

Pictured side by side are the Philips Respironics PR System One (lower left) and the ResMed S9 (upper right) continuous positive airway pressure (CPAP) machines. Brandon Peters, M.D.

It is a common question, especially when first diagnosed with sleep apnea: Do you have to use CPAP forever? Continuous positive airway pressure (CPAP) can effectively cure sleep apnea, but it may not be the most appealing treatment for everyone. How long do you have to use it? What alternatives exist to CPAP? Learn about whether you need CPAP forever and what to do so that you don’t.

Factors Leading to Sleep Apnea

First, it is important to recognize that not everyone has sleep apnea for the same reasons.

It may be dependent on your anatomy, the structures within your nose and throat and the position of your jaw and tongue. These predispositions may be present from birth and persist throughout life. A broken nose may lead to a deviated septum. Tissues in the nose, called turbinates, may swell in response to allergies. Over years, mouth breathing, teeth position, and other factors may change how well the airway can be maintained during sleep.

There are also transient and reversible factors that contribute to sleep apnea. In some cases, people only experience sleep apnea or snoring during certain scenarios. Alcohol and sleeping on one’s back (in a supine position) often make these conditions worse. Nasal congestion due to a cold or allergies may also exacerbate the disorders. REM sleep, which occurs more towards morning, may provoke it.

Weight gain makes sleep apnea worse. The accumulation of fat tissues at the base of the tongue and along the airway may narrow it.

Aging may lead to a loss of muscle tone and more collapsibility of the airway. Women beyond the age of menopause are at higher risk due to a loss of hormones, including progesterone.

As you might expect, some of these factors are reversible, and others are not.

Does CPAP Cure Sleep Apnea?

Sleep apnea is improved by CPAP as the device creates a constant airflow that keeps the airway from collapsing during sleep.

While it is used, sleep apnea can fully resolve. CPAP is not a cure in the sense that a limited period of use will not result in structural changes that can lead to discontinuation of therapy. It only works when you use it. Like a pair of glasses, in which you can see when you wear them, a CPAP will help you to breathe and sleep better whenever and only if it is used. Put it aside, and your condition will return as the predisposing factors never really went away.

Interestingly, many people will note a few days of residual benefit when they stop using CPAP or take a break. This is due to decreased swelling along the airway. As snoring and sleep apnea resume, the swelling returns and so do the symptoms of the condition.

Is CPAP Forever?

When asked if CPAP is forever, the short answer for most people with sleep apnea is that CPAP is the most effective treatment that currently exists. This doesn’t necessarily mean that it is forever, however.

It is important to reflect on the factors contributing to your condition.

It may be helpful to discuss and identify these with your sleep specialist. Weight loss can be hugely beneficial. If your condition is exacerbated by allergies, treatment may help. If it occurs only during pregnancy, this too will resolve in time.

Many people with sleep apnea will put up with the inconvenience. Interacting with the device for a few minutes per day and using it through the night leads to significant benefit. The nuisance is worth the trade off of better quality sleep, improved daytime alertness and function, and decreased risk for long-term health problems. Some get so great a benefit that the device ultimately can’t be pried from their hands.

Technology is advancing in every aspect of life, including the treatment of health conditions like sleep apnea. These devices are getting smaller, quieter, easier to use, and less intrusive. Certainly not everyone wants to use or tolerates CPAP. Alternatives exist, including oral appliances and surgical options, and more are being developed all the time. You may not have to use CPAP for the rest of your life because something better will come along.

If you choose to use CPAP, don’t view it as a life sentence. Instead, recognize it for the opportunity that it is: a simple intervention that can change your life for the better. If reversible contributions exist, including excessive weight, get to work to make the changes to put it aside for good.

Source:

Kryger, MH et al. "Principles and Practice of Sleep Medicine." Elsevier, 5th edition, 2011.

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