Why CPAP may not be your best bet for sleep apnea

CPAP is the gold standard for Sleep Apnea treatment, but when is it NOT the right answer?

diagnosis of sleep apnea

For anyone who's thought they or a loved one may have sleep apnea, there's no doubt you've heard about CPAP machines as the main treatment for this common sleep disorder.  CPAP stands for Continuous Positive Airway Pressure and its main goal is to keep your airway open while you sleep, preventing you from having "apneas", or stops in your breathing.  While there are other solutions for sleep apnea like oral appliances, neither may be the end solution and your insurance company could make it an even longer road to get to the treatment that works best.

If At First You Don't Succeed...

After your initial overnight sleep study, your sleep doctor is able to interpret all of the data collected and determine a diagnosis for your sleep disorder.  The range of breathing disturbance per hour (called your AHI; Apnea/Hypopnea Index) can vary for some people from over 100 per hour to around 0 per hour.  Anything over five is considered dangerous and your next step is to find out what type of therapy will get you under 5 per hour.

The first step to treatment is usually a CPAP machine.  Generally, this involves another overnight treatment trial in the lab so the sleep technicians can see what's happening while you use the CPAP machine that same night.  Most insurance companies approve this as the initial treatment and require that you try it first.  After a trial period, you'll come back in so that your machine data can be downloaded and checked to make sure it's working.  If the CPAP machine didn't work in getting your sleep apnea under control, the sleep doctor will have to try something else.  There are other types of PAP therapy that are essentially "steps up" from CPAP: 

man with cpap machine for sleep apnea
  • BiPAP - Bi-Level Positive Air Pressure

    • Uses two different air pressures to blow airway open. A higher pressure to blow the airway open and a lower pressure to allow for exhaling.
    • May work better for treating sleep apnea in people who have difficulty tolerating CPAP.
  • BiPAP S/T - Bi-Level Positive Air Pressure Spontaneous Timed

    • Delivers airflow similar to a standard BiPAP; However the S/T model will initiate breaths for you if you stop breathing – responding by delivering air in a set time frame if one is not taken spontaneously by the patient.
    • Works well for patients with central sleep apnea (where your brain stops telling your muscles to breathe).
  • ASV - Adaptive Servo-Ventilation

    • A form of Positive Airway Pressure that continuously monitors the patient’s breathing pattern in detail, and when it detects pauses or reductions in breathing, the machine will intervene to maintain steady breathing. When the breathing problems ends, the machine “backs out” gently.
    • Works well for patients with central sleep apnea (where your brain stops telling your muscles to breathe).

So Now We're Good, Right?

Hopefully the additional sleep therapy study will be the one that works and you can go home and get a good night's sleep (that's our goal here, of course).  The problem is, most insurance companies don't allow a sleep doctor to jump right to a certain therapy, but requires that they try each one in succession before moving on to the next.  This can be incredibly frustrating for patients and providers.  Co-pays, additional nights in the sleep center and trying to adjust to a new normal of using a sleep mask at night can be a lot to deal with.  We definitely get it.  We have a great staff of clinicians who will counsel with you and billing specialists that work with your insurance company to get the treatment you need.  

sleep specialist discussing sleep disorder treatment with patient

Our mission at Innovative Sleep Centers is to give you back your sleep and your health.  Like orthodontic braces, you can't just put them on and have straight teeth in a matter of months.  You have to go back in for adjustments over the course of your treatment.  This is how we must look at treating sleep apnea.  We have long-term PAP compliance rates of 80% (the national average is around 50%) because we work with you to find the optimal treatment that will be easy to stay compliant with.

Give Us a Call Today

If you suspect you or someone you know has sleep apnea, take our Sleep Apnea Questionnaire and then give us a call to schedule a consultation with our providers.  We are here to help you on your journey to sleep better and live healthier!