Prior to the 1980s one of the only available treatments for sleep apnea was a tracheotomy. This involved making an incision in the trachea and inserting a breathing tube to give the patient relief from their sleep apnea. The invention of the Continuous Positive Airway Pressure (CPAP) machine changed this and provided a method of assistance that did not involve having a tube shoved into the patient’s neck. In the years following the invention of the CPAP there have been variations of the original device, which include the BIPAP and APAP machines. These machines are all used to treat sleep apnea but work a little bit differently and each type may be better suited for different needs.
The Invention of the CPAP
The CPAP was invented by Professor Colin Sullivan and his coworkers at Sydney University in 1981. Dr. Sullivan began studying sleep apnea and focused on the condition in dogs that had breathing difficulties such as English bulldogs and pugs. It was during these studies that he found a connection between breathing and sleep and Dr. Sullivan went to study the condition further at the Royal Prince Albert Hospital in Australia.
He came to the conclusion that a solution may be found with a device that could pump air into the respiratory tract. The first CPAP device constructed by Dr. Sullivan consisted of a breathing mask that was connected to a vacuum cleaner engine with a hose. This device was fitted to the snout of a dog with results that were found to be promising for human use.
In 1980 Dr. Sullivan received an opportunity to test the device on a construction worker that had come into the hospital for help with his sleep apnea. His apnea was severe enough that Dr. Sullivan recommended a tracheotomy but the patient refused the treatment and agreed to try the CPAP machine. The machine was tested on the patient using several different settings of pressurized air until they fell asleep and were able to breathe normally for several hours while they slept. The machine would later be tested on several other patients and later accepted as a treatment for sleep apnea by the medical community.
How it Works
The modern CPAP machine works by delivering a set amount of air pressure into the airway to keep breathing regular and oxygen available to the patient. The air travels from a flow generator through a hose that is attached to a nose mask. This air pressure supports breathing and helps keep the airway unobstructed. The air pressure delivered through a CPAP machine is continuous and this can sometimes be uncomfortable for certain people since they will be exhaling against pressurized air. While it can work very well for some individuals others may prefer using a BIPAP or APAP machine in it its place.
The BIPAP and APAP Machines
The Bi-level Positive Airway Pressure (BIPAP) machine was developed in the 1990s and is often used in patients that are unable to adjust or have not found relief with the CPAP. Unlike the CPAP machine, which delivers a constant flow of air, the BIPAP delivers two levels of air pressure during the night. A higher level of pressure is delivered while the patient is inhaling and a lower pressure level when they are exhaling.
This reduces the effort it takes to exhale and can be more comfortable for the patient especially if they experience issues with anxiety and claustrophobia when using a CPAP. However, the pressure on a BIPAP machine must be carefully monitored and adjusted since it is not automatic. This machine is usually recommended by doctors for people that are also suffering from heart problems or lung disease.
Using an Automatic Positive Airway Pressure (APAP) machine is also an option for people that have sleep apnea. This machine can automatically regulate the pressure it delivers to the patient to maintain the pressure at the lowest setting possible to keep the patient’s airway open. Since the pressure is automatically adjusted for each breath it can be the most comfortable option for people with sleep apnea.
Determining the Best Solution for Your Needs
The CPAP, BIPAP and APAP machines can all reduce or eliminate the symptoms of sleep apnea and are usually prescribed based upon what the doctor considers to be best for the patient’s individual needs.
These machines are usually not very large and can be very simple and convenient to transport. A doctor will work with the patient to find the ideal setting for them or an APAP machine can be used to evaluate pressure needs on a breath-by-breath basis. Patients also have the option of using a nose mask or a full-face mask depending on their personal preferences. Sometimes a patient will have to try more than one type of machine before they find the best solution for their sleep apnea.