Information & Instructions
Snoring and obstructive sleep apnea (OSA)
Snoring is a common sleep disorder that can affect all people at any age, although it occurs more frequently in men and people who are overweight. Snoring has a tendency to worsen with age. Forty-five percent of adults snore occasionally, while 25% are considered habitual snorers. Occasional snoring is usually not very serious and is mostly a nuisance for the bed partner of the person who snores. However, the habitual snorer not only disrupts the sleep patterns of those close to him, he also disturbs his own. Habitual snorers snore whenever they sleep and are often tired after a night of what seems like quality rest. Medical assistance is usually needed for habitual snorers to get a good night's sleep.
Habitual snorers can be at risk for serious health problems. Obstructive sleep apnea is an illness that is often associated with chronic snoring. This condition creates several problems, including: Long interruptions of breathing (more than 10 seconds) during sleep caused by partial or total obstruction or blockage of the airway. Serious cases can have total blockage episodes hundreds of times per night. Frequent waking from sleep, even though he or she may not realize it. Snorers with obstructive sleep apnea sleep lightly to try to keep their throat muscles tense enough to maintain airflow.
Blood oxygen levels are often lowered, which causes the heart to pump harder and blood pressure to rise. The result is a poor night's sleep, which leads to drowsiness during the day and can interfere with the person’s quality of life. Prolonged suffering from obstructed sleep apnea will result in higher blood pressure and may cause enlargement of the heart, with higher risks of heart attack and stroke.
What causes obstructive sleep apnea and snoring?
The physical obstruction of the flow of air through the mouth and nose is the cause of snoring. The walls of the throat vibrate during breathing, resulting in the distinctive sounds of snoring. Air flow can be obstructed by a combination of factors, including:
- Obstructed nasal airways: Partially blocked nasal passages require extra effort to transfer air through them while sleeping. This can pull together or collapse the non-rigid soft and dangling tissue of the throat, resulting in snoring. Some people snore only during allergy seasons or when they have a sinus infection. Deformities of the nose such as a deviated septum (a "crooked" wall that separates one nostril from the other) or nasal polyps can also cause obstruction and sleep problems.
- Poor muscle tone in the throat and tongue: Throat and tongue muscles can be too relaxed, which allows them to collapse and fall back into the airway. This can result from deep sleep, alcohol, and some sleeping pills. Normal aging causes further relaxation of these muscles and increases the potential for snoring.
- Bulky throat tissue: Being overweight can cause bulky throat tissue. Also, children with large tonsils and adenoids often snore.
- Long soft palate and/or uvula: One of the most common causes of snoring, a long soft palate or uvula (the dangling tissue in back of the mouth) can block the opening at the back of the throat. When these structures vibrate and bump against one another during sleep, the airway becomes obstructed and causes snoring.
What obstructive sleep apnea and snoring treatments are available?
If you occasionally snore, you can try the following behavior changes to help treat the problem:
- Lose weight and improve your eating habits.
- Avoid tranquilizers, sleeping pills, and antihistamines before you go to bed.
- Avoid alcohol, heavy meals, or snacks at least four hours before you sleep.
- Establish regular sleeping patterns. For example, try to go to bed at the same time every night.
- Sleep on your side rather than on your back.
- Prop the head of your bed — not just your pillows — up four inches
If none of the above mentioned behavioral changes help snoring, talk to your doctor. Sleep Specialist, Pulmonologists, Otolaryngologists (ear, nose, and throat doctors) offer a variety of treatment options that may reduce or eliminate snoring or sleep apnea.
Continuous Positive Airway Pressure (CPAP): A patient may be fitted with a nasal mask which forces air through the upper airway. The air pressure is adjusted so that it is just enough to prevent the upper airway tissues from collapsing during sleep. The pressure is constant and continuous. This should help the person breathe better and sleep through the night. CPAP is considered the gold standard and first line of treatment for OSA. Other Positive Airway Pressure (PAP) devices: In a minority of the cases, your sleep apnea may require a more complex device such as Bi-Level or other respiratory assist devices. Your CPAP/Sleep Specialist can give you more information on this.
For more information on CPAP, head over to our Frequently Asked Questions page and if you still aren’t finding the answers you need, get in touch with our experts. We’re happy to help!
Other treatments for obstructive sleep apnea and snoring
There are more than 300 devices on the market to help prevent snoring; however, none of these devices address all of the underlying anatomical problems that cause snoring (such as nasal obstruction and being overweight) and likely will not completely solve your issues around snoring and OSA. Surgery may be needed to correct physical problems, however, are associated with some risks and complications. Your Sleep specialist can review these with you. Snoring and sleep apnea surgeries include:
- Uvulopalatopharyngoplasty (UPPP or UP3): A surgical treatment that tightens and restructures the flabby tissues in the throat and palate. This is often prescribed for people who have moderate or severe obstructive sleep apnea.
- Laser-assisted uvula palatoplasty (LAUP): A laser procedure removes the airway obstruction. This treatment is performed under local anesthesia in a doctor's office and is intended for snorers and for people with mild obstructive sleep apnea.
- Somnoplasty: This is a minimally invasive procedure that uses radiofrequency energy to shrink excessive tissue in the palate, uvula, and tongue tissue. This treatment can also be used to relieve nasal obstruction.
- Genioglossus and hyoid advancement: This is a surgical treatment for sleep apnea which prevents the collapse of the lower throat by pulling the tongue forward.
- Septoplasty and turbinate surgery: This is a surgery to fix blockages in the nose and help air through the nose smoothly and quietly.
- Tonsillectomy: Removing the tonsils and adenoids may be needed to prevent snoring, particularly in children.
- Inspire: Inspire therapy is an innovative treatment option for people with moderate-to-severe obstructive sleep apnea who are unable to use or get consistent benefits from CPAP. For more information, visit inspiresleep.com.
What is CPAP?
C.P.A.P is an acronym that stands for Continuous Positive Airway Pressure. It usually refers to a machine that is used to treat Sleep Apnea.
Sleep Apnea is a condition where a person's airway relaxes during sleep, and the muscles of the mouth or throat can block the airway. Blockages are called "apneas", and they can interrupt breathing, raise blood pressure, and cause snoring.
What is CPAP therapy?
A CPAP machine or Sleep Apnea machine forces air through the airway during sleep. This helps the person breathe and maintain good blood oxygen levels throughout the night.
What is a CPAP machine?
While commonly referred to generically as "CPAPs", there are several different types of Sleep Apnea machines. These include CPAP, APAP and BiPAP / Bi-Level machines.
A CPAP machine blows one set air pressure, whereas an APAP automatically adjusts the pressure on a breath by breath basis. A BiPAP or Bi-Level machine blows two different pressures during inhalation and exhalation. If you have Sleep Apnea, using CPAP, APAP, Bi-Level or BiPAP machines can make a big difference in overall health and quality of life.
There are many benefits to using a Sleep Apnea machine. First, it can reduce snoring, caused by apneas. PAP therapy can help prevent these by blowing an air stream aimed at keeping your air passages open.
Many people may find using a PAP device can help increase energy, and help prevent daytime fatigue. Compliance with PAP therapy can also lower blood pressure and has many positive heart-healthy benefits.
To learn more about HealthPartners Home Medical and the sleep therapy equipment options we provide, visit our services page. Whether you need high-quality medical equipment or advice on what would work best for your condition, our expert staff is here to help.
CPAP masks:
A CPAP mask is the main point of contact that provides air from a CPAP machine to your airways via your nose, mouth, or both. If someone has a mask with a good fit, it can help make CPAP therapy more comfortable and effective. A face mask is easily the most important part of your CPAP therapy. It can come in three styles: full face, nasal, and nasal pillow. Let's go over these in greater detail:
Full Face- A full face is a mask that fits around the mouth AND the nose. They are intended mostly for individuals that breathe through their mouth. The mask is gently strapped in place with headgear.
Nasal Mask- Covers the nostrils and is gently held in place by headgear. As you breathe through the nose, the air is delivered to the nasal mask and enters the airway by breathing normally.
Nasal Pillow Mask- Seals around the base of the nostrils using a soft pillow head in place by headgear. This adds comfort for some, and many swear by their pillow mask.
You may not realize it, but in some ways, a mask chooses you, not the other way around! You'll get the most out of CPAP therapy if you get one that accurately reflects how you actually sleep, not how you'd like to sleep. Start by asking anyone who's been around you when you sleep, do you sleep with your mouth open? If you sleep with your mouth open, you'll need a full face mask, or you could use a chinstrap and try a nasal. If you sleep with your mouth shut, you have a few more options. You can go with a nasal pillow or a nasal mask.
We carry a wide variety of CPAP masks sure to fit your needs. Our respiratory therapists are here to help you find the perfect fit and instruct you on how to use it. Get started by exploring our CPAP masks today!
Maintaining your CPAP/Bi-Level equipment
Daily:
Wipe the cushion with a hot, soapy cloth and rinse well, or clean using a baby wipe. Ivory or baby shampoo are recommended; never use alcohol or bleach. Empty the distilled water from the humidifier chamber and air dry.
Weekly:
All the following products can be hand washed in mild detergent, (Ivory Dish soap or baby shampoo) use hot water and let air dry. Do not use Dawn or Palmolive as that will damage the silicone. It's never recommended to use household cleaners, bleach, or other harsh cleaners to disinfect parts and supplies. Harsh chemicals can leave a residue that pollutes the air you breathe, causing it to become toxic.
- Headgear or chin strap – DO NOT dry or iron
- Mask frame and cushion
- Tubing – Heated or non-heated tubing can be submerged in water
- Humidifier/Water Chamber – As needed: Soak for 30 minutes in 1 part white vinegar and 3 parts water, rise will with warm water and let air dry.
Filters:
Non-Disposable: Rinse filter 1-2 times per months, air dry before placing in unit. The reusable filter will need to be replaced. Many machines use both disposable and reusable filters, and you typically can't replace disposable filters with reusable filters. Reusable filters are also fairly inexpensive.
Disposable: Check periodically and replace every 3-6 months or when dirty. They are designed to filter the air (much like the air filter in your car or house) and keep mold, dust, and other irritants out of the therapy air you breathe. Disposable filters come in different styles and sizes (depending on the kind of machine you have) and are relatively inexpensive.
Tubing:
Tubing is the connection from the machine to the CPAP mask and are usually made of stiff plastic. Hoses are can be 19mm wide with 22mm ends, and most are 6 feet long or 15mm wide, 4mm smaller than standard hoses. Some hoses can be heated to add comfort (as this can eliminate the formation of condensation inside the hose which can cause water to hit the nose or face). Most are fairly inexpensive.
Humidifier chamber:
The humidifier chamber is the container that holds distilled water for humidification of CPAP air.
Check out our cleaning supplies and accessories today!
Replacement schedule:
Following a replacement schedule for the parts on your machine is very important. If you do not, the quality of the air you breathe will go down. This means you could have greater exposure to infections, mold, colds, and other harmful bacteria. Following a good replacement schedule will help keep you healthy, and it may also mean your machine lasts longer too.
Check with your insurance company for frequency as to when supplies are covered.
- 1 per 3 months: Tubing, heated tubing, full face mask, nasal/pillow mask
- 1 per 6 months: Headgear, chinstrap, water chamber, non-disposable filers
- 2 per 1 month: Nasal pillows, nasal cushions, disposable filters
- 1 per month: Full Face mask cushion
Mask fitting tips:
Mask fitting exercise: Put mask in place on face and turn from side to side adjusting equipment to minimize leaks. Red lines on your face upon waking should last no longer than 1 hour.
The mask seal does not have to be perfect: PAP machines are designed to make up for small leaks. However, you will not tolerate leaks blowing in your eyes so you will need to adjust. Any leak should only be near or at the bottom of the mask. We expect your mask to leak slightly at night.
Do not over-tighten the headgear straps, tighter IS NOT better, we expect minimal leak.
First, try re-positioning the mask or headgear before tightening the headgear straps. Mask leaks are expected due to changing sleeping positions. Try pulling the mask away from your skin allowing the cushion to re-inflate to minimize the leak. If you struggle for a good fit, try turning the PAP off and then readjust the mask by pulling it away from your face and then turning the PAP back on.
Humidifier tips:
Humidifiers can be adjusted to increase or decrease the amount of moisture according to your comfort level. You may need to adjust this frequently at first, but then might only change it with seasonal weather changes.
Try INCREASING the humidity if:
- You experience a dry, irritated nasal passage or throat.
- You have a runny, drippy nose or sneezing fits after using CPAP.
- You experience nasal congestion during or after CPAP use.
Try DECREASING the humidity if:
You have excessive condensation or “rain out” in the tubing or mask. Otherwise, keep the tubing warm during the night by running it underneath the blankets or pillow, or insulate it with a wrap. If these solutions do not work, it may be that the air temperature of the room is too cold and turning up the home thermostat will be necessary.