Ashwin Lewis
Sleep therapy equipment is used to treat sleep disorders, such as sleep apnea, which affects a person's breathing during sleep. The most common treatment for sleep apnea is the Continuous Positive Airway Pressure (CPAP) machine, which delivers pressurised air through a mask to keep a person's airway open during sleep. Other equipment used for sleep therapy includes oral appliances, positional therapy devices, sleep apnea pillows, and surgically implanted devices that deliver impulses to stimulate the diaphragm.
| Characteristics | Values |
|---|---|
| Treatment for | Sleep apnea, parasomnia disorder, snoring, sleepwalking |
| Equipment | CPAP machines, oral appliances, BiPAP machines, APAP machines, PAP machines, Inspire therapy |
| Mechanism | Continuous positive airway pressure, oral appliance therapy, neural stimulation, nutritional and exercise therapies, surgery |
| Features | Masks, straps, tubes, motors, air filters, heated humidifiers, adjustable pressure settings |
| Cost | Medicare may cover a three-month trial period and contribute to the cost of machine rental |
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What You'll Learn
CPAP machines
CPAP (continuous positive airway pressure) machines are a leading option for treating sleep apnea. They deliver a constant stream of pressurised air to keep the airway unobstructed throughout the night. This is achieved by delivering continuous air through the mouth and/or nose via a mask that fits over just the nose, or both the nose and mouth. Straps are used to position the mask on the face, with a tube connecting it to the machine's motor.
There are also alternatives to CPAP machines, such as oral appliance therapy, positional therapy, weight management, and surgery. Oral appliance therapy involves a custom device that fits over the teeth and opens the airway by positioning the jaw more favourably. Positional therapy encourages side or stomach sleeping, as those who sleep on their backs are more prone to apnea episodes.
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Oral appliance therapy
Oral appliances are custom-made by dentists who specialize in oral appliance therapy, ensuring a comfortable and effective fit for each patient. These devices are typically recommended for patients with mild to moderate obstructive sleep apnea (OSA) and can also help eliminate chronic snoring. While CPAP therapy is considered the "gold standard" treatment for OSA, oral appliance therapy offers a viable alternative for those who have difficulty tolerating CPAP machines or masks.
Mandibular advancement devices work by connecting to both the upper and lower teeth, advancing or moving the jaw forward to clear the airway. Tongue-stabilizing devices (TSDs) are another type of oral appliance that helps clear the airway by moving the tongue forward. In children, rapid maxillary expansion (RME) devices are used to permanently expand the width of the roof of the mouth, providing more space for airflow.
Overall, oral appliance therapy is a safe and effective alternative to CPAP therapy for treating obstructive sleep apnea and improving sleep quality. It is customizable, non-invasive, and easy to use, making it a preferred choice for many patients seeking a more manageable solution for their sleep apnea and snoring issues.
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Positional therapy
People with positional sleep apnea typically experience symptoms such as snoring, choking, and sleep disruption when sleeping on their backs. Changing to a side-sleeping position can help normalise breathing and reduce these symptoms. Positional therapy devices provide tactile feedback to encourage side sleeping. These devices include lumbar or abdominal binders, backpacks, full-length pillows, and alarms with positional sensors.
One such device is NightBalance, a compact, easy-to-use, mask-free treatment for positional obstructive sleep apnea. Worn across the chest with a soft, adjustable strap, NightBalance delivers gentle vibrations that prompt users to shift to their sides without disturbing their sleep. The device automatically adjusts the intensity of the vibrations to provide the necessary therapy. NightBalance is intended for adults with mild to moderate positional obstructive sleep apnea and is prescription-only.
While CPAP (continuous positive airway pressure) therapy is the current first-line treatment for sleep apnea, up to two-thirds of patients do not adhere to it. Positional therapy is a well-tolerated alternative that can be used as a second-line treatment or in conjunction with CPAP. It is recommended that patients undergo a sleep study to document any sleep apnea events and their corresponding sleeping positions before initiating positional therapy.
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BiPAP machines
BiPAP (bilevel positive airway pressure) machines are used to treat sleep apnea and other sleep-related breathing disorders. They are typically used at home, but can also be used in hospitals to treat breathing emergencies. BiPAP machines are non-invasive and deliver pressurised air into the lungs through a mask worn over the face. The mask can cover the nose, mouth, or both, depending on the user's needs.
Before starting BiPAP therapy, a respiratory therapist may need to calibrate the machine and adjust the settings according to the patient's needs. It is important to follow the healthcare provider's instructions on when and how to use the BiPAP machine to ensure optimal results. If the user experiences any symptoms or problems while using the BiPAP machine, they should consult their healthcare provider for guidance.
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Neural stimulation
One neural stimulation approach is through the use of a hypoglossal nerve stimulator, an implanted device that helps manage OSA by electrically stimulating the hypoglossal nerve. This nerve stimulation causes the tongue to move forward, opening the airway with each breath and improving breathing. The device is controlled by a hand-held remote and can be turned on and off as needed. The surgery for this device is an outpatient procedure lasting around two hours, and most insurance plans will cover at least some of the costs. As of 2023, the only hypoglossal nerve stimulator approved by the FDA is the Inspire device.
Upper Airway Stimulation Therapy is another form of neural stimulation used to treat OSA. It involves implanting a small device under the skin in the upper chest, which helps to keep the upper airway open and reduces breathing pauses. This procedure can be performed as a same-day hospital procedure, and the device is also controlled by a remote. Upper Airway Stimulation Therapy is approved by the FDA and provides an alternative for those who cannot tolerate CPAP machines, which are commonly used to treat OSA but often cause discomfort and compliance issues.
Transcranial electrical stimulation is another neural stimulation technique that involves administering small pulses of electricity to the brain. This method has been found to increase time spent in deep sleep, which is important for memory organisation and waste clearance. While this approach has been deemed safe, with no serious side effects reported in over 18,000 sessions, it has not yet translated into widely available home devices.
Additionally, auditory stimulation has emerged as a promising non-invasive tool to enhance sleep slow waves, which are linked to sleep restoration and tend to diminish with age. While lab-based studies have shown beneficial effects, further research is needed to determine its effectiveness in real-life settings.
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