What is Sleep Apnea?

Sleep Apnea is the most common sleep disorder, affecting around 5% of men and 2% of women in the 30+ age group. There are an estimated 120,000 sufferers in Ireland, the majority of whom have not yet been diagnosed.

Sleep apnea is identifiable in the sufferer’s breathing pattern during sleep; they will have periods when they stop breathing altogether and become silent, followed by a significant snore as they suddenly recommence breathing again. The silence is caused by the apnea – the pause in breathing. Snoring is not the problem, but always accompanies sleep apnea and is often quite loud and disruptive. The pauses/apneas can occur hundreds of times per night, and the sufferer will usually be unaware of their behaviour.

These apneas occur when the muscles and tissue relax, which surround the airway at the back of the throat. As they relax they block the narrow airway causing temporary stoppages in breathing. The brain reacts to the breathing signals – oxygen deficiency and increased irregular heart rate – and triggers a response which is to pull in a breath suddenly. The person snores loudly as they start to breathe again. This event causes what we call micro-arousals, meaning the person has woken up very briefly though they usually are not aware of it. As this behaviour persists all night, sleep quality becomes fragmented and sleep is not as refreshing as it should be.

Symptoms of Sleep Apnea

The most frequent symptom of sleep apnea is tiredness during the day. Other symptoms may include: dry mouth in the mornings, excessive perspiration, frequent urination at night, memory loss, headaches, exhaustion, nightmares, sexual dysfunction, irritability, aggression, loss of concentration, depression.

Sleep apnoea can cause not only a drop in quality of life but also a shorter life expectancy due to secondary diseases. If untreated the condition can cause cardiac disrhythmia, cardiac insufficiency, seizure (stroke), cardiac arrest, apoplectic seizure (stroke), cardiac arrest, and psychological problems. Medical studies have shown that 50% – 70% of people with sleep apnoea suffer from high blood pressure, compared to only 10% – 20% of the population at large.  Unfortunately sleep apnoea is not usually identified as a cause of these symptoms and so they are treated but not solved.

Contributing Factors:

Weight: Tissue in the neck becomes and causing airway collapse. (Collar size 17 or greater)

Sedatives and alcohol: cause airway muscle to relax leading to collapse. The consumption of alcohol significantly worsens the condition.

Smoking.

Upper respiratory tract infection: e.g. head-cold or nasal allergy, causes swelling

of the airway passages and can aggravate the condition.

Age: The muscles become more flaccid with age, losing some tone.

I think I have Obstructive Sleep Apnea – How do I get started on CPAP?

Firstly, your GP must refer you to a sleep specialist/sleep clinic.

After a discussion with the sleep clinic, they will decide whether a sleep study is needed, which in turn will determine whether treatment is required. They will then put you in contact with a CPAP supplier, or you can select your own if you have a preference, with their approval.

Sleep studies are performed in both public and private clinics, with varying waiting times. Sleep studies can be carried out either in hospital or at home, but each clinic has its own procedures.

Should I rent or buy my CPAP

We strongly advise that you rent your machine for the first two months at least. If you then wish to purchase it, we deduct the rent already paid against the purchase price.

The main factor to take into consideration is whether you can reclaim some of the rental cost from the Drugs Payment Scheme (DPS). If so, rental will make more sense and cost less.

If purchasing, the only reimbursement is a 20% tax rebate from Revenue.

We will explain the DPS to you at set-up, or see page 3 of our Obstructive Sleep Apnea Booklet.

Which CPAP machine should I choose?

Your sleep clinic might have a say in this as they want to be sure you have a modern machine, which will have the necessary specification and will record the data they need to see.

There are slight differences between machine models in features and prices, but all current machines from the main manufacturers do the same thing to the more or less the same standard.  

If you are starting CPAP with us we will supply the latest model device and we can explain the difference between the machines we offer. All have two-year warranties.

When will I feel the benefits of using CPAP?

There is no concrete answer to this question! Some people feel benefit after their first night, some take weeks before they notice a difference. You have probably been struggling with Sleep Apnea for some time, so don’t worry if you don’t feel a difference in the first few days. Above all, you need to persist when you commence CPAP in order to give it every chance to be effective and to improve the chance of long-term success.

You will have a review appointment with your consultant/clinic after a few weeks/months, and at that stage the benefits or any improvement in symptoms will be discussed.

Should I use a nasal or full-face mask?

If you have any history of the following: broken nose, deviated septum, frequent nasal congestion, frequent rhinitis/sinusitis or general problems with a stuffed/blocked nose, it is almost certain you will be better off with a full-face mask.

Neither mask type is ‘better’ – it is very much a matter of which suits you best, and a mask that someone else finds excellent could be the wrong one for you.

When we first meet you to supply CPAP, mask selection is the most important part of the discussion, and it is our job to guide you through the options and select the best.

Is CPAP a long-term treatment?

It usually is. Your need for CPAP is usually based on physical factors at the time of diagnosis. If there is weight loss, the need for CPAP may be revised.

The majority of Sleep Apnea sufferers are overweight to some degree, but not all.

There is no way to say whether weight loss will result in discontinuing treatment.

Most people who commence CPAP continue using it very happily in the long term.

Is CPAP noisy?

When correctly used, CPAP is surprisingly quiet and barely noticeable in a bedroom. It is not silent – there is a sound from the machine as it is effectively an air pump, and a slight sound from the mask as every mask has a vent through which carbon dioxide is released.

At higher pressure settings there is more sound as there is more pressure in the mask and the machine is working slightly harder.

CPAP will only be loud when masks is either poorly fitting or worn out, and the noise results from mask leak.

All modern machines have very acceptable sound levels, but mask fit will have a significant impact on sound.

Invariably, the sound produced by CPAP is vastly preferable to the sound of an obstructive sleep apnoea sufferer snoring loudly and interrupting the sleep of their partner.