FAQs
Please contact us if you have a question that isn't on this page.
- What do we mean by a big picture approach to sleep apnea treatment?
- Why do we work with physiotherapists?
- What benefits can you expect from our programmes?
- What is sleep disordered breathing?
- What is OSA?
- What is PAP therapy?
- What is CPAP?
- What is APAP?
What do we mean by a big picture approach to sleep apnea treatment?
We see healthy sleep as just one part of our client's general health and well being. Poor sleep often leads to daytime consequnces such as sleepiness, fatigue and reduced productivity. Equally, what we eat and drink, and our level of physical activity impacts on our sleep quality.
Our approach looks to improve your sleep health not only with PAP devices (e.g. CPAP and APAP) but also by facilitating the lifestyle changes you need to improve your general health. Our physical activity programmes will be individualised to your abilities and goals. Importantly, our approach is one that is realistic and based on scientific principles.
Why do we work with physiotherapists?
Physiotherapists have worked in the area of sleep medicine for over twenty years. Indeed they have been pivotal in advancing the treatment of sleep disordered breathing. These advances have most often been in the the practical applications of treatment.
Physiotherapists are generally good communicators who keep their patients informed and advised. Their hands-on approach to treatment allows them to be a trusted mentor to those commencing or struggling with mask breathing support.
More traditionally acknowledged are their skills in exercise and physical activity prescription. This allows physiotherapists to undertake integrated treatments which more comprehensively address the well being of clients with sleep disordered breathing.
Along with their skills in communication and hands-on patient care, physiotherapists bring their knowledge of anatomy and training in the scientific principles of medical treatments together to achieve excellent results for clients.
What benefits can you expect from our programme?
Our programme takes a big picture approach as we specifically address both your sleep and general health.
Our sleep health programme is designed to give you the advice and training you need to maximise the benefits of PAP therapy. These benefits include, a reduction in sleepiness and fatigue, better quality sleep so you awaken feeling refreshed, improved concentration, and a reduction in the physical manifestations of sleep apnea such as snoring. We not only address the very important issues of mask fit and machine function, but we also help you understand what other factors impact on sleep health which may be contributing to your symptoms.
Our general health programme is integrated with PAP initiation and is designed to improve fitness and promote weight loss. Because our partners are physiotherapists, you benefit from their training and experience. Setting individual goals which are addressed by a realistic and achievable physical activity or exercise programme is the key to our approach. Some of the benefits you may experience include:
- greater weight loss which is maintened
- increased energy and endurance
- reduced risk of many diseases (including heart disease, high blood pressure, diabetes and osteoporosis)
- enhanced sense of mental well-being
- better sleep
- improved flexibility making it easier to move around
What is sleep disordered breathing?
Sleep disordered breathing describes any abnormal pattern of respiration which occurs when a person is asleep. Within the medical community, there is some controversy as to what constitutes sleep disordered breathing and who should be treated.
Sleep disordered breathing can be seen as a continuum. At one end is simple snoring where vibration within the airway is produced secondary to a loss of muscle activity in the airway during sleep, and at the other end are severe breathing abnormalities where breathing becomes shallow during sleep (nocturnal hypoventilation). This abnormality can lead to respiratory failure and serious health effects. In between these two extremes are those clients who have varying degrees of obstructive and central sleep apnea.
What is OSA?
Obstructive sleep apnea (OSA) is associated with a closure of the upper part of the airway during sleep (often in the area around the back of the tongue). This results in an absence of air flowing into the lungs (apnea). During an apnea the subject does not breath as the airway is blocked. The subject makes continued efforts to breathe, and it is this struggling that eventually causes them to momentarily wake. This short waking period is known as an arousal. This continual waking in response to OSA is the reason patients often report sleepiness and fatigue.
Sleep apnea varies markedly in its severity and effects. Apneas may last from 10 seconds to in some cases many over minute. These breathing events that occur in sleep are associated with a drop in the blood oxygen level, increases in blood pressure, fluctuations in the heart rate and rhythm and a release of stress hormones. OSA is also associated with a number of adverse heath effects including high blood pressure, heart disease, stroke and more recently has been linked to diabetes.
The bottom line is that OSA can have serious medical consequences and it should be investigated and managed whenever it is suspected.
What is PAP therapy?
PAP stands for postive airway pressure therapy. It refers to when air is delivered to a patient at a level above that of the atmospheric pressure. When we are discussing patients using PAP for sleep disorders, an interface held on with straps is usually used. PAP therapy may take a number of forms and new modes of this therapy are devised regularly. The main forms of PAP used for treating obstructive sleep apnea is CPAP and APAP.
Other forms of PAP include bilevel ventilation where the device acts like a respirator (artificial breathing machine) to increase the patients breathing. This type of therapy is usually indicated when the person has a disorder of shallow breathing in sleep know as nocturnal hypoventilation. Newer modes of PAP include adaptive servo ventilation. These devices use modern computing to treat central apnea in those cases were more simple modes are shown to be ineffective.
What is CPAP?
CPAP stands for continuous positive airways pressure. It refers to when air is delivered to a patient at a level above that of the atmospheric pressure. The term CPAP is generally used when we are referring to a single level of pressure which is applied across the entire night. Other modes of pressure delivery exist which apply the pressure in different ways including APAP and bilevel ventilation.
The manufactures of CPAP have sought to improve the comfort of CPAP by adding various features including a ramping (i.e. gradual increase) of pressure as desired by the patient and a dropping of the pressure as the patient breaths out (C-flexTM and EPRTM).
When we talk about using CPAP during sleep we are in the majority of cases delivering the pressure via an interface which is held in place with straps. The interfaces are of many different types and include nasal masks, full face masks, mouthpieces and nasal prongs.
What is APAP?
APAP stands for automatic positive airways pressure. APAP is know under a number of names including aPAP, autoset and autoPAP. This mode of PAP therapy is also found in a number of different brands of products.
The choice of whether to use APAP versus CPAP will depend on many different factors. These include:
- the effectiveness of either modality
- the instructions of the treating physician
- the desires of the client
- the potential benefits of one mode over another
- the budget of the client
In most cases the choice of the type of device will depend on the individal situation and many different factors will be weighed by the client and their heakthcare advisors. A period of carefully monitored device usage on a rental basis is always recommended prior to making definitive choices about which device or mode will be used long-term.
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