PPC apparatus: indication, effectiveness and treatment

CPAP apparatus: indication

A device designed to assist the patient's breathing, continuous positive pressure ventilation is mainly indicated in the context of sleep apnea syndrome.

Sleep apnea: CPAP device to assist the patient's breathing

2 to 4% of the population suffers from it, obstructive hypopnea sleep apnea syndrome affects many individuals, sometimes without their knowing it. It is manifested by long and frequent pauses in breathing during nocturnal sleep: in these conditions, sleep is interspersed with micro-awakenings. Upon awakening and throughout the day, the patient with sleep apnea feels an disproportionate fatigue. Another harmful consequence of this sleep disorder, the level of oxygen in the blood decreases considerably: the heart risk is important.

When sleep apnea is diagnosed – after a medical examination polysomnography or ventilatory polygraphy – the patient may be prescribed the use of a continuous positive airway pressure machine. The CPAP device allows the patient to maintain constant breathing throughout of the night, for a truly restful sleep.

Note: sleep apnea is characterized when the apnea hypopnea index (< em>IAH) is greater than 5. From 5 to 15, sleep apnea is considered mild, it is moderate between 15 and 30 and severe above. em>

CPAP prescription: symptoms of sleep apnea

CPAP is indicated to treat sleep apnea. But how to detect this pathology? Symptoms s observe at night on the one hand, during the day on the other.

Nighttime Symptoms of Sleep Apnea:

• Loud snoring.
• Interrupted breathing.
• Suffocation.

Daytime Symptoms of OSAHS:

• Fatigue and drowsiness.
• Drowsy driving.
• Difficulty concentrating.
• Headaches.

The occurrence of these symptoms should lead to extensive medical examinations in order to prescribe a CPAP device.

Which risk factors for OSAHS?

Some individuals are predisposed to sleep apnea, including men, the elderly, and people suffering from overweight or even 'obesity. The latter are indeed likely to develop a syndrome of obstructive sleep apnea hypopnea insofar as fatty deposits settle in the back of the throat, obstructing the respiratory tracts during the night.

The CPAP device: how it works

The CPAP device comes in the form of a nasal or bucco-nasal mask, to be worn at night. The CPAP mask is connected to a small box. It is through this box that air is blown into the patient's airways.

The air blown by the machine allows keeping the airways open: air circulation is thus guaranteed during all phases of sleep, and the patient is no longer subject to breathing pauses. p>

Depending on the results of the medical examinations intended to diagnose sleep apnea, the doctor prescribes the appropriate equipment for the patient. Different CPAP device settings vary, including:

• The intensity and number of levels of air pressure delivered during the inspiratory and expiratory phases.
• Whether or not there is an intelligent autopilot mode.

From the point of view of ergonomics: the CPAP device weighs between 1 and 2 kg. The mask is held on the face via adjustable straps. The generation of the air flow induces a noise of 25 to 30 dB.

CPAP equipment: efficiency

The OSAS is at origin of intense fatigue and poor oxygenation. As a treatment for sleep apnea, the CPAP device should provide the following benefits: reduction in daytime fatigue, optimal attention and improved concentration, reduction in the risk of heart attacks, disappearance of states of drowsiness and improvement of blood pressure.

The effectiveness of continuous positive airway pressure has been proven: patients who opt for this treatment for sleep disorders claim to have improved the quality of their daily routine at night and day, contributed to a favored life as a couple and extended their life expectancy.

Please note: more than 70% of patients get rid of their apnea syndrome sleep with regular use of the CPAP device.

The effectiveness of CPAP equipment nevertheless remains linked to the patient's level of tolerance, directly depending on their reaction to adverse effects.

CPAP equipment: adverse effects and reimbursement conditions.

Adverse effects and tolerance to CPAP ventilation:

A large majority of patients – 70-80% – tolerates night fitting. This tolerance is directly dependent on the following criteria:

• The degree of patient follow-up : technical follow-up and medical follow-up must be sufficient to support, reassure and measure the effectiveness of the treatment in order to comfort the patient in his use of the apparatus.
• The occurrence of undesirable side effects: adverse effects of CPAP equipment are few. Among them, skin irritation, rhinitis and conjunctivitis.
• Discomfort tolerance: although discreet and quiet, the device remains bulky. It can also involve a dry mouth felt as unpleasant. Finally, the mask can represent an obstacle to the intimate life of the couple.

CPAP device: reimbursement.

In 2017, the annual cost of equipment amounts to around €850. Social Security reimburses the device up to 60%. Please note that reimbursement is subject to strict treatment compliance conditions.