Continuous Positive Airway Pressure ( CPAP) Devices
The American College of Physicians (ACP) review of clinical evidence found that because of it’s effectiveness, CPAP therapy remains the best first option for treating sleep apnea after an initial diagnosis. Unfortunately, some patients don’t use CPAP therapy once prescribed.
Practice, perseverance and peer support are critical to success, with discomfort of CPAP masks being the main reason why patients abandon their CPAP treatment. Despite this, CPAP therapy is the most effective treatment for sleep apnea.
In Australia, CPAP therapy has been very expensive due to the market dominance of Resmed, Philips Respironics and F&P. Typical prices from these companies for CPAP Machines have been $1500 and $2,500 for the Auto (APAP) machines.
Fortunately, sleep apnea healthcare is now more affordable in Australia with CPAP Machine and Mask Packages costing $799 and Auto Machine and Mask Packages costing $999
Mandibular Advancement Devices (MAD)
A secondary alternative to CPAP therapy is known as Mandibular Advancement Devices (MAD) where a mouth piece is custom made and designed to pull the lower jaw forward in an attempt to increase upper airway respiration.
This can be effective in treating sleep apnea, but success is not guaranteed.
The cost of such an oral device is painful to the jaw and pocket. Around one third of patients need to replace their MAD within three years, further adding to their cost of CPAP therapy. Additional costs and the inconvenience of frequent dental visits also need to be considered with this MAD form of CPAP therapy.
Provent Therapy
Another alternative to CPAP therapy (not recommended by the ACP) is the Provent device.
The concept of this device is to block most of the nasal expiration effort with disposable strips of special tape over the nostrils.This creates a positive pressure upon exhalation, if the patient breathes through their nose.
This is a costly treatment, typically more than $1,300 per year in Australia, and is ineffective if the patient opens their mouth to breath.
Weight Loss
Weight loss can have a positive impact on obstructive sleep apnea (OSA).
According to the ACP report, rates of OSA are on the rise, as are obesity and other weight-influenced diseases such as Type 2 diabetes. Being overweight is one of the most significant risk factors for developing obstructive sleep apnea. The ACP’s first recommendation to doctors is that they encourage their overweight and obese patients with sleep apnea to lose weight.
A combined approach of initial CPAP therapy, exercise and reduced calorie intake supported and encouraged by associated health care professionals and peers support is the best recipe for success.
Thanks to Dr. Michael J Breus, who inspired this blog post. You can read his article here.