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This article is evidence-based, verified by Dr. Ahmed Zayed.
CPAP or continuous positive airway pressure is a treatment method commonly associated with sleep apnea. However, there are a variety of other uses for CPAP systems not related to sleep.
You can use CPAP while awake. For example, physicians use CPAP to treat chronic obstructive pulmonary disease, respiratory ailments in preterm infants. Additionally, the Food and Drug Administration recently suggested the use of CPAP devices for the treatment of patients suffering from COVID-19.
This article will explain the basics regarding CPAP, followed by a detailed discussion of four of the uses of CPAP while awake.
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What Is CPAP? 🌬️
CPAP or continuous positive airway pressure is a type of ventilator that applies low-level pressure to the lungs constantly. A CPAP keeps airways open in people able to breathe on their own. However, these people need assistance in keeping their airways open at the end of an exhalation. This process increases oxygenation levels and reduces the effort of breathing.
CPAP is an alternative to positive end-expiratory pressure (PEEP) or a mechanical ventilation system. PEEP devices only impose positive pressure at the end of expiration, whereas CPAP devices provide positive pressure throughout the entire breathing process.
A CPAP system consists of a bedside pump that gently pushes a stream of air through a tube that delivers air to the user. CPAP systems include one of the following delivery systems:
- A mask that covers the mouth and nose.
- A mask that only covers the nose, called nasal continuous positive airway pressure or NCPAP.
- A tube that ends in prongs that fit inside the nostrils.
Selecting the best CPAP system can be confusing with so many models to choose from these days. Click here for an article on CPAP machines guaranteed to take the guesswork out of that decision.
4 Possible Uses for a CPAP While Awake 🌬️
There are a variety of uses for CPAP while a person is awake. Although sleep apnea remains the primary beneficiary of CPAP, there are other uses for the system to include the treatment of chronic obstructive pulmonary disease, treating preterm infants with respiratory ailments, and for treating respiratory viruses.
Additionally, doctors and clinicians recommend using CPAP while awake for getting accustomed to using the system while sleeping for the treatment of sleep apnea.
Chronic Obstructive Pulmonary Disease
CPAP is frequently used to treat Chronic Obstructive Pulmonary Disease (COPD), a group of chronic inflammatory lung diseases that obstruct airflow from the lungs. According to the Mayo Clinic, two of the most common conditions associated with COPD include chronic bronchitis and emphysema.
Chronic bronchitis is an inflammation of the bronchial tube linings which carry air to and from the alveoli (air sacs) of the lungs. Similarly, emphysema is a condition in which irritating gases and cigarette smoke destroy the alveoli located at the end of the lung’s smallest air passages (bronchioles)
In broader terms, COPD is associated with hypoxia or the state of having lower than normal levels of oxygen in arterial blood as the result of any kind of interruption of normal respiration. Put another way; hypoxia is the state or condition in which the oxygen supply is insufficient to sustain healthy life functions due to breathing deficiencies.
Symptoms of COPD include difficulty breathing, coughing, wheezing, and mucus (or sputum) production. COPD is typically caused by smoking or by long-term exposure to particulate matter or irritating gases. (The Environmental Protection Agency defines particulate matter as a complex mixture of tiny particles and liquid droplets.)
COPD is progressive, meaning that its severity increases over time. Additionally, people suffering from COPD have an increased risk of developing lung cancer, heart disease, and a variety of other severe medical conditions.
However, on a positive note, a study published in the International Journal of Chronic Obstructive Pulmonary Disease concluded that “CPAP may be a useful alternative” to more invasive forms of respiratory assistance like intubation (the insertion of a breathing tube).
Additionally, a more recent study published by Respirology determined that CPAP can increase the ability to inhale, particularly for patients suffering from emphysema.
Respiratory Ailments in Preterm Infants
CPAP is widely used to treat respiratory illnesses in preterm or premature infants. The American Academy of Pediatrics reported that one of the most common diagnoses of Neonatal Intensive Care Units (NICUs) is Apnea of Prematurity.
Apnea or temporary cessation of breathing in preterm babies is often associated with a variety of respiratory disorders commonly treated with CPAP. For example, physicians frequently use CPAP in the treatment of infantile respiratory distress syndrome (IRDS).
Also known as surfactant deficiency disorder (SDD). IRDS is a syndrome in preterm infants associated with a lack of the development of pulmonary surfactant. (For those unfamiliar with the term, pulmonary surfactant is a complex mixture of carbohydrates, lipids, and proteins that prevents the partial collapse or incomplete inflation of the lungs.)
The American Academy of Pediatrics (AAP) reported that Nasal continuous positive airway pressure (NCPAP) is “effective” in reducing the severity and frequency of apnea in preterm infants. Additionally, “limited evidence suggests” that the use of CPAP “may be more effective” in reducing apnea than other systems like conventional respirators.
However, the AAP noted that more extensive studies examining the full scope of the advantages and disadvantages of CPAP in treating apnea are needed.
The U.S. Food and Drug Administration released an “immediately in effect” guidance policy on March 22, 2020, addressing an anticipated increased need for ventilators, accessories, and other respiratory devices, during the COVID-19 pandemic.
Additionally, the guidance policy stipulated that their recommendations were intended to “augment” and not replace any procedures and specific controls developed by the Centers for Disease Control and Prevention and other health care organizations.
That policy recommended that health care providers and facilities use “FDA-cleared” conventional full-featured ventilators whenever possible to support patients suffering from respiratory failure.
However, in the event, the number of available ventilators is running low, the FDA recommended using “alternative devices” capable of delivering pressure support such as CPAPs. The guidance also recommended that patients put on CPAP machines receive appropriate monitoring whenever available.
Facilitating Ease of Use for Sleep Apnea Patients
The most common use for CPAP machines is the treatment of obstructive sleep apnea, a potentially severe sleep disorder occurring when a person’s breathing starts and stops during sleep. The University of California Berkeley School of Public Health recently reported on CPAP’s effectiveness in treating sleep apnea.
However, it also reported that about 50 percent of people with a doctor’s prescription for a CPAP machine fail to use them for the instructed amount of time. There are a variety of reasons why people avoid following their doctor’s instructions. Those include discomfort while wearing the device’s mask.
For that reason, UC Berkeley recommends that people start by using the machine for short periods while awake. (They use the example of using the device while watching television.) Once an individual becomes accustomed to the feel of the mask, he or she can begin wearing it while sleeping for increasing amounts of time for a period of one to three months.
Home PAP Devices in COVID-19 Infected Patients
There is one caveat to using CPAP machines at home for persons infected with COVID-19. Yale University published an article on April 20, 2020, recommending the installation of a circuit device providing proper filtration for CPAP machines. According to Yale, CPAP machines were not designed for use with highly contagious viruses like COVID-19.
Dr. Meir Kryger, professor of medicine at Yale, along with Dr. Robert Thomas of Harvard, published their circuit design in the Journal of Clinical Sleep Medicine. The circuit uses off-the-shelf parts. However, Dr. Kryger warned that only an equipment provider or respiratory technician should install the device.
There are a variety of uses for CPAP devices while the patient is awake. In the wake of the global COVID-19 pandemic, CPAP devices are increasingly important as tools to treat aggressive respiratory ailments.
Dr. Ahmed Zayed, MD, holds a baccalaureate of Medicine and Surgery. An avid contributor to the Huffington Post and Chicago Tribune, Dr. Zayed believes in providing accurate and accessible information to general readers. With years of writing and editing content in the medical niche, Dr. Zayed likes to think of himself as a man with a mission, keeping the internet free of false medical information.
- Harvard Medical School Publishing: Is your CPAP machine making you sick?
- University of Michigan Medical Gateway: CPAP Therapy for Obstructive Sleep Apnea
- Healthline: Understanding COPD Hypoxia
- The Mayo Clinic: COPD
- Medicine Net: Hypoxia and Hypoxemia
- The Environmental Protection Agency: Particulate Matter
- ResMed: CPAP for COPD
- National Institutes of Health: Continuous Positive Airway Pressure Increases Inspiratory Capacity of COPD Patients
- National Institutes for Health: Continuous Positive Airway Pressure Increases Inspiratory Capacity of COPD Patients
- American Academy of Pediatrics: Apnea of Prematurity
- The American Thoracic Society: The Role of Surfactant in Lung Disease
- The U.S. Food and Drug Administration: Ventilator Supply Mitigation Strategies
- Centers for Disease Control and Prevention: Interim Infection Prevention and Control Recommendations
- The Mayo Clinic: Sleep Apnea
- UC Berkeley Health and Wellness Alerts: Learning to Live with CPAP
- Yale University: Sleep apnea devices need a filter for use in COVID-19
- Journal of Clinical Sleep Medicine: Home PAP devices in COVID-19 infected patients
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