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Sleep Apnea

What is sleep apnea?

Obstructive sleep apnea is a sleep disorder where a person’s breathing is involuntarily interrupted by choking episodes that last 10 seconds or more. The throat relaxes during sleep and causes the airway to collapse; this prevents air from entering the lungs. Because the breathing is momentarily interrupted, an individual’s oxygen level will fall to low levels which causes strain on the heart. These episodes may occur repeatedly throughout the night and can lead to transient wakings and fragmented sleep. Untreated obstructive sleep apnea results in serious health complications and poor sleep quality that makes you feel tired during the day.

How common is sleep apnea?

According to The Canadian Thoracic Society’s Sleep Disordered Breathing Clinical Assembly:

  • 1 of every 5 adults has at least a mild form of sleep apnea (20%)
  • 1 of every 15 adults has at least moderate sleep apnea (6.6%)
  • 2 to 3% of children are likely to have sleep apnea
  • Over 1 in 4 (26%) Canadian adults have a high risk of having or developing obstructive sleep apnea.
What are possible diseases/complications associated with OSA?
  • High blood pressure (hypertension)
  • Type II Diabetes
  • Congestive heart failure
  • Heart attack/stroke
  • Depression
  • Obesity 
  • Impotence
  • Post operative complications
Is there a cure for sleep apnea?

Unfortunately, there is no permanent “cure” for sleep apnea, however there are a variety of effective treatments such as CPAP therapy, which remains the gold standard. These treatments aim to minimize the overall impact of sleep apnea.

What are some treatment options for sleep apnea?

There are a few treatments for OSA. In mild cases your physician might recommend lifestyle modification such as weight loss or oral appliance. However, if that does not alleviate your symptoms or your sleep apnea is diagnosed as moderate to severe, the most effective treatment option is a positive airway pressure device to open the blocked airway. CPAP is considered the Gold Standard for treatment of obstructive sleep apnea.

How do I know if I have sleep apnea?

If any of the following apply to you, please complete the Quiz to find out if you are at risk for sleep apnea:

  • Loud and persistent snoring
  • Pauses in breathing or gasping during sleep
  • Excessive daytime Fatigue
  • Associated health conditions such as obesity, high blood pressure, diabetes, heart disease
  • Family history of snoring or obstructive sleep apnea
  • Poor sleep patterns/insomnia
  • Poor memory/judgement
  • Confirmation of disturbances from bed partner or family members
What are common signs and symptoms associated with OSA?
  • Excessive daytime sleepiness/fatigue
  • Observed episodes of interrupted breathing
  • Loud Snoring
  • Waking frequently at night (frequent nighttime urination)
  • Morning headaches
  • Nocturnal gasping/choking
  • Restless sleep
  • Nocturnal heartburn
  • Waking with dry mouth or sore throat
  • Night sweats
  • Depression/moodiness
  • Decreased irritability
When should I see a Doctor?
  • Snoring wakes you or others
  • Waking up short of breath or gasping/choking
  • Excessive daytime fatigue
  • Pauses in breathing during sleep
  • Family history of sleep disordered breathing
  • Chronic nasal congestion affecting your sleep


What is a CPAP and how does it work?

Continuous positive airway pressure therapy provides treatment for those patients who have been diagnosed with obstructive sleep apnea. To provide treatment, the CPAP machine gently applies air pressure in your airway to prevent the throat from collapsing, allowing uninterrupted breathing during sleep. Therapy is administered through, either, a nasal mask, nasal pillows, or full-face mask.

What is the difference between Standard CPAP and Auto CPAP therapy?

The difference between the two machines is the mode in which the air pressure is delivered. Auto CPAPs will automatically adjust pressure to meet your specific requirements by measuring the change in the level of resistance in your breathing. Whereas a standard CPAP machine is titrated to a specific maximum required pressure that stays constant throughout the duration of use.

What is Ramp Setting?

Most CPAP machines nowadays are built with a ramp feature that allows the patient to start therapy comfortably at a lower pressure which gradually increases over a pre-set period of time. This comfort feature makes falling asleep with a CPAP much easier and gives the user time to adjust to the CPAP before increasing to the required pressure setting. The ramp setting is activated by pushing the ramp button which is usually placed on the faceplate of the machine. It is usually identified by the triangle symbol displayed on it.

What is heated tubing?

A heated tube is used to prevent condensation or “rain out” from occurring while using a CPAP machine with a humidifier. The heated tubing is built with a small heating coil that keeps the air at an adjustable pre-set temperature ensuring higher humidity delivery in cooler environments. Switching to a heated hose can also help alleviate symptoms of nasal congestion and dryness.

When should I replace my CPAP machine?

The lifespan of your CPAP machine largely depends on the level of care you provide the equipment. If the level of noise in your machine is increasing or if you feel that the machine is no longer providing the same benefits that it used to then it is time to change your CPAP. Most insurance plans will cover you for a new machine every 2-5 years.

Is it important to use distilled water?

Though using tap water with your CPAP machine can be a lot more convenient, it is important to use only distilled water in your CPAP humidifier to increase the longevity of your machine. Tap water contains minerals which can build up in your water chamber and cause the machine to breakdown faster. Tap water also contains multiple bacteria strains which will promote respiratory infections.

Can I travel with my CPAP?

If you prepare in advance, traveling with a CPAP can be very easy. Check with your airline if you can bring your CPAP with you as a carry on or if it should be packed in your checked luggage. To avoid hauling a heavy bag or having your CPAP take a lot of precious luggage space, opt for using a travel CPAP as they are very portable, easy to use and do not weigh as much as a regular machine.

Can I use a battery with my CPAP?

Backup battery packs are a great option for traveling/camping with CPAP machine or if you live in an area with frequent power outages. You can typically get up to 1-2 nights worth of CPAP usage from a battery pack if you have a proper mask seal and turn off your humidifier. Higher CPAP pressure (ie >10cmh20) will unfortunately decrease the battery life. When choosing a battery, it is important to make sure that it is compatible with your specific CPAP machine.


Which mask is compatible with my CPAP machine?

Almost all CPAP masks are designed with a universal fit so that they are compatible with virtually any CPAP machine. When choosing a CPAP mask consider comfort, size, and the fit before making your selection. There are three main types of CPAP masks; Nasal, Nasal Pillows and Full-Face.

How to stop a mask leak?

Having a leak in your mask can be very annoying. It can cause air to blow into your eyes or face and cause irritation. One reason there might be a leak could be a mask with an improper fitting which can leave space between your mask and your face. This could be due to too loose or excessive tightening of the mask, movement during sleep, or just the way your masks sits on your pillow. To fix this pull the mask away from your face then reseat the mask again or adjust the headgear. Accessories such as CPAP pillows, mask liners or nasal gel pads are also great options to achieve a good seal.

Why is there condensation/water droplets in my mask/hose?

When you use your CPAP machine with the humidifier it heats the air that flows through the hose toward the mask. As the air flows through the temperature drops and the air cools down enough to condense into water droplets within the tubing and mask. To avoid this you can wrap your hose in a tubing insulator or switch to a heated- hose. Ensure room temperature is as close to 20º C as possible and there isn’t a fan blowing in the direction of the CPAP, or an open windows close to the machine.

How to remedy waking up with dry mouth?

If you are using your CPAP with a humidifier and still experiencing dry mouth it may be due to a mask leak during the night. Try readjusting your mask to see if it alleviates the symptoms of a dry mouth. If you use a nasal mask try switching to a full-face mask as you might be opening and breathing through, your mouth during the night. Also keep your humidity levels as high as you can comfortably tolerate.

CPAP and anxiety

If you are a new CPAP user or have recently been diagnosed with sleep apnea, you may have some anxiety when it comes to sleeping with a mask or initiating therapy. CPAP masks are created with ventilation to avoid buildup of carbon dioxide, so you will not suffocate when using a CPAP machine. To get the maximum benefit out of CPAP therapy start to slowly build a habit of using the machine on a nightly basis. Try wearing the mask during the day while watching television or reading so that you can practise breathing with the mask and get used to the feel of it against your face with distraction. Most importantly you need to be patient and have a positive attitude towards therapy.

How/When should I clean my equipment ?

You should clean the cushion of your mask on a daily basis upon waking with either CPAP wipes or warm water and soap. It is important to note that only wipes designed for cleaning CPAP masks should be used as alcohol or moisturizer-based wipes can damage your cushion. The headgear, hose and water chamber should be cleaned once a week; soak in warm water and mild soap for 10-15 minutes and then rinse and air-dry. Rinse the filter once a month and air-dry before inserting it back into the machine. Never place scents or oils in your CPAP chamber- distilled water only.

How often should I replace my mask/tube?

Despite cleaning your mask/hose regularly there can still be a buildup of bacteria present in your mask and prolonged use of it can cause skin irritation/infection and respiratory illnesses. Even when just exposed to air, the silicone will break down and cause mask degradation over time. It is important to replace your mask/hose once every 6 months to ensure you get the most benefit out of your CPAP therapy. You should also replace the filter on your CPAP once every 3 months to increase the longevity of your machine. Replacing these parts will also ensure maintenance of optimum therapy.

Why is my mask causing skin irritation?

If you are experiencing skin irritation it may be because your mask is either too tight or too loose on your face. Try readjusting for a better fit. Another reason may be that your mask is now old and worn out so you should look into replacing either the cushion or if possible, the complete mask. Old masks may be harbouring high bacteria levels. You can also try using mask liners which can act as a barrier between the mask and your skin.



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