CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) is a form of positive airway pressure ventilator, which applies mild air pressure on a continuous basis to keep the airways continuously open in persons who are able to breathe spontaneously on their own. A continuous positive airway pressure (CPAP) machine was initially used mainly by patients for the treatment of sleep apnea at home. Obstructive sleep apnea occurs when the upper airway becomes narrow as the muscles relax naturally during sleep. This reduces oxygen in the blood and causes arousal from sleep. The CPAP machine stops this phenomenon by delivering a stream of compressed air via a hose to a nasal pillow, nose mask, full-face mask, or hybrid, splinting the airway (keeping it open under air pressure) so that unobstructed breathing becomes possible, therefore reducing and/or preventing apneas and hypopneas. It is important to understand, however, that it is the air pressure, and not the movement of the air, that prevents the apneas. When the machine is turned on, but prior to the mask being placed on the head, a flow of air comes through the mask. After the mask is placed on the head, it is sealed to the face and the air stops flowing. At this point, it is only the air pressure that accomplishes the desired result. This has the additional benefit of reducing or eliminating the extremely loud snoring that sometimes accompanies sleep apnea.
The CPAP machine blows air at a prescribed pressure (also called titrated pressure). The necessary pressure is usually determined by a sleep physician after review of a study supervised by a sleep technician during an overnight study (polysomnography) in a sleep laboratory. The titrated pressure is the pressure of air at which most (if not all) apneas and hypopneas have been prevented, and it is usually measured in centimeters of water (cmH2O). The pressure required by most patients with sleep apnea ranges between 6 and 14 cmH2O. A typical CPAP machine can deliver pressures between 4 and 20 cmH2O. More specialized units can deliver pressures up to 25 or 30 cmH2O.
Since continuous compliance is an important factor in successful treatment, it is important that patients who travel have access to equipment. Progressively, PAP units are becoming lighter and more compact, and often come with carrying cases. Dual-voltage power supplies permit many units to be used internationally.
As with all durable medical equipment, proper maintenance is essential for proper functioning, long unit life and patient comfort. The care and maintenance required for PAP machines varies with the type and conditions of use, and are typically spelled out in a detailed instruction manual specific to the make and model.
Most manufacturers recommend that the end user perform daily and weekly maintenance. Units must be checked regularly for wear and tear and kept clean.
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