Snoring, Sinus & ENT Specialist
- Dr Kenny Peter Pang
- Ear, Nose & Throat Consultant
- MBBS MRCS(Edinburgh)(UK)
- Masters Medicine (ORL)
- Founder, ASEAN Sleep Surgical Society
- Founding Member, International Surgical Sleep Society
- Member, American Academy Sleep Medicine
- Member, Singapore Sleep Society
- Member, World Sleep Society
- Board Member, Italian Sleep Disorders Board
- Member, British Association of Sleep Surgeons
- Member, European Academy of Sleep Medicine
What is nasal CPAP?
This is a non-invasive method of treatment, it entails using continuous positive airway pressure by a mask worn by the patient on the nose or the face throughout the night. CPAP is the most effective and frequently used treatment for OSA, but the issue of compliance is a major problem.
It only works if the patients the mask, it would not work if it was kept in the closet.
As the patient does not use the mask the whole night, it would not be effective.
How many types of CPAP are there?
CPAP machines come in the (a) manual and the (b) automatic.
- Manual – this machine delivers a fixed pressure of air, pre-determined by your sleep specialist based on either an overnight sleep study with the CPAP on, or an average recording of the automatic CPAP use over a month. This machine may be cheaper than the automatic version but require closer monitoring and follow up by the sleep specialist.
- Automatic – this is a dynamic machine that will titrate and adjust the amount of pressure required by the patient (user) based on each breath to breath variation. This machine records the average duration of use by the patient every night, records the average pressure required by the patient, records the leak of air between the patient’s nose/mouth and the mask, and provides an AHI reading, which tells the doctor how many times per hour the patient still stops breathing (if at all) while on the machine. This machine may be slightly may expensive but is probably more user friendly for the patient and more comfortable for usage.
Failure of CPAP
The CPAP machine is very effective provided the patient can tolerate it the entire night. Compliance is the main problem. Most people do NOT use the machine the entire night and every night of the week. Hence, the treatment effectiveness is based entirely on the patient’s use.
Long term follow up and research done on over 20,000 patients on CPAP and those who underwent surgery. This study was published in the American Otolaryngology Journal in 2006, showed that patients who underwent surgery LIVED LONGER on average than patients who were using CPAP.