CPAP: Learn about the Indications

Continuous positive airway pressure (CPAP) is a way of forced delivery of air into the lungs, wherein airflow is introduced into the airway to ensure that the airway remains patent. Many conditions cause a collapse of airway leading to reduced oxygenation, CPAP helps in correcting it. CPAP therapy can be provided in the hospital or may be prescribed by the doctor for usage at home.

Procedure of CPAP

CPAP can be administered with the help of different types of machines. The machines are designed to deliver air flow at a constant pressure. They may also have other features like humidification

• Nasal CPAP: air is delivered via nasal prongs or a small mask which fits over the nose
• Nasopharyngeal CPAP: a small tube is introduced into the nose which open into the back of the throat; air is delivered via this tube, bypassing the nose
• Face mask CPAP: a mask covering the nose and mouth is placed on the face through which air is delivered at a constant pressure.

The masks, prongs or the nasopharyngeal tube are connected via tubing to a motor which is programmed to delivered air at a particular pressure. The machine also contains straps for securing the mask or the nasal prongs in place.

For patients using CPAP at home it is essential that they use it every time they sleep or take a nap.

Indications for CPAP 

CPAP is indicated for adults and children for different conditions. They are:

• Adult
• Obstructive sleep apnoea
• Neuromuscular disorder
• Ventilator weaning
• Chronic obstructive pulmonary disease with exacerbation
• Congestive heart failure with pulmonary edema
• Pneumonia
• Neonates, infants, paediatric patients
• Pneumonia
• Myopathies
• Muscle fatigue
• Obstructive sleep apnoea syndrome
• Asthma bronchiolitis
• To prevent lung collapse.

Preparation of CPAP

If you will be using CPAP at home you will first have to go through a set of sleep tests where the optimal pressure for CPAP will be decided. A pulmonologist will also help you decide on which mask and machine settings work best for you. Now there are auto titrating machines available in the market which can decide the optimal pressure required, with the help of computer algorithms and pressure sensor transducers.

Complications with CPAP

Using CPAP at home will help in improving your sleep if used regularly. Initially when you start using the machine you might feel uncomfortable, claustrophobic or embarrassed; but with time as you get used to the machine you will be able to sleep comfortably. Some of the complications seen with the usage of the machine are:

• Congestion
• Runny nose
• Dry mouth
• Nose bleed
• Abdominal distention and bloating
• Irritation and redness of skin where the mask is placed.

It is important that the mask and tube be kept clean; it advisable to change them every 3 to 6 months.

Resources

• Continuous Positive Airway Pressure (CPAP),Venessa L. Pinto; Sandeep Sharma
• Treatment of obstructive sleep apnea in primary care.,Am Fam Physician.  2004; 69(3):561-8 (ISSN: 0002-838X)