CPAP (Continuous Positive Airway Pressure) is a proven and very effective treatment for Sleep Apnea. Various types of machines are available that deliver airflow / oxygen to a patient through different types of masks that are worn during sleep. The modern CPAPs are smaller and make less noise than older versions. Humidifiers can also be used with the CPAP to moisturize and heat the air being breathed in by the patient. CPAPs are prescribed by your Doctor and the individual companies that provide the device provide support and technical help with them.

Indications: CPAP is indicated for any patients who are experiencing symptoms of sleep apnea or snoring. They are designed to help push air and oxygen through the nose and mouth to get to the patient’s lungs. They are best used for patients with moderate to severe Sleep Apnea or for patients with any associated medical problems like heart disease or conditions, obesity or inability to use other treatment options. A referral will be made to an experienced and certified Sleep Center {link to Cornell Sleep Center, NYU Sleep Center} who will ultimately determine if this is a viable option for you.

Preparation: A referral will be made to an experienced and certified Sleep Center {link to Cornell Sleep Center, NYU Sleep Center} who will go over in detail what preparation is needed to use CPAP. This will typically include a comprehensive exam and additional sleep studies to properly titrate the CPAP settings for you.

What to expect during use: some patients fall in love with their CPAP right from the first time they use it and others may struggle with it and ultimately give up using it. Often it is advised in the beginning that you wear it at home while not sleeping to get used to it. There are many different machine and mask types that are available and getting the right fit for you is crucial. It does need to be worn every night to work properly and insurance companies will monitor your use in order to provide coverage for it. Some patients may benefit from Septoplasty or Turbinoplasty before using CPAP to make more room in their nose so the CPAP will be more comfortable.

Follow Up: it is very important that a repeat sleep study be done to make sure that the CPAP is working properly. Periodic follow up studies will also be done to ensure that good long-term outcomes are being achieved. Good follow up is crucial to achieving success with CPAP. If a patient ends up not tolerating CPAP then it is important to look at other options like Septoplasty, Turbinoplasty and Oral Airway Appliances. Dr Jafri also believes it is very important to work on all aspects and symptoms of sleep apnea and will make direct referrals for you to internists, cardiologists, psychiatrists, nutritionists, physical therapists, physical trainers, acupuncturists, holistic practitioners, dentists and oral surgeons as needed for your specific case.

Costs: CPAP is covered by insurance and the Sleep Center that will be working with you will work with you to obtain coverage. It is important to use the CPAP every night to maintain the insurance coverage.

Risks: all treatments have inherent risks, benefits, alternatives and complications associated with them and to the specific individual patient being treated. The Sleep Center will review these with you in detail and answer any questions you have before you proceed with any treatment plan and as part of the process of whether to proceed or not.

ALTERNATIVES TO CPAP: having worked with and treated patients with Sleep Apnea and Snoring for the last 10 years, Dr Jafri has noted that large numbers of patients either can not tolerate CPAP or they use it for a period of time and then stop using it. Many patients simply cannot even wear the CPAP due to feelings of claustrophobia. This is a terrible scenario for the patient because they remain at risk for the severe medical consequences of Sleep Apnea and Snoring but are not being treated for it.

Dr Jafri has developed an alternative treatment plan for these patients who either can not or do not want to use CPAP as their primary treatment regimen. By combining nasal airway surgery (Septoplasty, Turbinoplasty) with an Oral Airway Appliance, Dr Jafri has been able to successfully treat patients with mild to moderate Sleep Apnea and Snoring. He has even been able to help some patients improve their severe sleep apnea by using this approach (for these patients doing something is better than doing nothing!).

The principal behind this approach is that by opening up both the nasal airway (Septoplasty, Turbinoplasty) and the oral airway / tongue / back of throat (Oral Airway Appliance), a patient will have excellent improvement in the 2 areas of obstruction that are causing their Sleep Apnea and Snoring problems. Dr Jafri has referred to this approach as Dual Airway Treatment (DAT).
This approach is providing an exciting, appealing and effective approach to help treat Sleep Apnea and Snoring. Dr Jafri is currently working on a clinical research paper to compare this approach directly with CPAP.

Additional clinical work is being started on the applications of Full Mouth Reconstruction procedures in combination with the Dual Airway Treatment (DAT).

CPAP Alternative Case Study