Continuous Positive Airway Pressure or CPAP (Continuous Positive Airway Pressure) machines are suitable treatments for patients with all levels of upper airway obstruction during sleep. whether it is a patient with normal snoring problems or with sleep apnea When choosing to use CPAP, choose Manual Pressure Setting (Manual CPAP) or use Automatic Pressure Adjustment (Auto CPAP) Well, this article has the answer.
Read more: What is a CPAP machine?
Understanding the selection of each type of CPAP machine
Choosing both types of CPAP is probably no different than buying a car. whether to choose a manual gear or automatic gear, the car we buy, whether it's a manual gear or automatic transmission can lead us to our destination as well
CPAP is the same regardless of whether you choose to use a manual pressure setting. or use automatic pressure adjustment It can widen the patient's airway while sleeping. It can improve the problem of snoring and/or sleep apnea of the patient as well.
But using an automatic transmission car will make the driver more comfortable Do not worry about gear adjustment like a manual transmission car. The same is true for using a pressure-adjusting CPAP. Patients will be more comfortable Because there is no need to worry about setting or adjusting the pressure used to treat snoring or sleep apnea.
In addition, using Auto CPAP is more comfortable. It's less uncomfortable than a constant pressure machine. Because the auto machine will adjust the air pressure level to suit the body automatically throughout the night When there are few symptoms The machine will give a pressure that is not high.
However, Auto CPAP machines have disadvantages as they are more expensive than Manual CPAP machines (See the price of each CPAP model.) as well as automatic transmission cars which are more expensive than manual transmission cars. Therefore, you should consider the various elements when choosing a CPAP machine carefully before making a decision.
The difference between Auto and Manual CPAP
The video clip below explains it clearly.
Disadvantages of Constant Pressure CPAP Machines (Manual CPAP)
1. May result in under treatment
when the nasal mucosa is swollen from colds or allergies, the patient gains weight (more fat will come around the upper respiratory tract) or older patients (organs in the upper respiratory tract such as the soft palate, uvula, base of the tongue, tonsils will sag down) will make the way narrowing of the upper respiratory tract
when using Manual CPAP preset pressure will reduce the air flow through the upper respiratory tract Making the treatment lower than it should be (under treatment) may cause the patient to return to a louder snoring sound. or have sleep apnea wake up feeling unrefreshed, tired, sleepy during the daytime
But if using Auto CPAP when the upper airway narrows The machine will automatically increase airflow into the upper airways. Make the results of the treatment still good. Despite the change in the size of the upper airway
2. It may result in receiving “more” treatment than it should be (over treatment).
When patients with allergic rhinitis there is a decrease in nasal air or patients who are overweight able to lose weight The upper airway is widened when using a pre-set pressure Manual CPAP. This causes more air to pass through the upper respiratory tract than it should be (over-treatment).
But if using Auto CPAP when the upper airway is wider The machine automatically injects air into the lower airways. Reduces the air flow through the patient's nose or mouth. Make patients more cooperative in using CPAP machines.
3. Feeling more uncomfortable
Manual CPAP machines are more uncomfortable to use. Especially if it has to be used at a high pressure level.
4. Constantly having to adjust the pressure setting to suit
When an event occurs that narrows or widens the upper airway For those who use Auto CPAP, the machine automatically adjusts the air pressure. There is no need to constantly reset the pressure.
For those who use Manual CPAP, in the event that the upper airway is narrowed may cause the patient to return to a louder snoring sound or have sleep apnea wake up feeling unrefreshed, tired, sleepy during the daytime Therefore, patients need to always adjust the appropriate pressure value.
Finding the right pressure In case of using a Manual CPAP machine
- Receive a sleep test (sleep test) at the hospital again. (1 night stay in the hospital) to reestablish appropriate pressure for the constricted upper airway (CPAP titration).
- borrow the device Auto CPAP from the company that sells it for 1-2 weeks to find the right pressure (Using the 90th or 95th percentile pressure: 90th or 95th percentile pressure) for upper airway constriction at that time. then bring that pressure Let's set a new pressure for the Manual CPAP machine.
Advantages of Auto CPAP Machines (Auto CPAP)
1. Get the right pressure to maintain through the night.
while the patient lies on his side The upper airway is wider than when lying on your back. If the patient is using Auto CPAP, the machine will automatically reduce the pressure in the upper airway. Make patients more cooperative in using CPAP machines.
But while the patient lies on his back long soft palate and the base of the tongue that grows will fall under the gravitational pull of the world Causing the upper airway to be narrower than when lying on the side, the Auto CPAP machine will automatically increase the pressure that blows into the upper airway. This makes it a more physiologically appropriate treatment.
Conversely, if the patient uses Manual CPAP, regardless of whether the patient is lying on their side or on their back, the device will inflate air into the upper airway at a constant or equal pressure, resulting in the air flowing through the upper airway in the upper airway. while lying on the side will be more than it should be (over treatment)
2. No need to wait to adjust the pressure by yourself.
at some time We may have physical conditions that change, such as weight gain. Or today, exercising or working tirelessly or drinking alcohol, etc. These all make us have more severe snoring and sleep apnea.
If we use an Auto CPAP machine, the machine will automatically adjust the pressure for us. For Manual CPAP machines, you have to adjust the pressure yourself.
3. Feel more comfortable
Users of Auto CPAP machines will feel more comfortable. less uncomfortable because the wind pressure is not high all night At times the pressure may drop. If the symptoms are mild, such as at the beginning of sleep or when sleep is not deep
4. Easy to use
Auto CPAP machine is easy to use, just press the power button. And in the long run, you don't have to keep adjusting the pressure.
when you know the advantages And the disadvantages of both types of CPAP machines, wouldn't be too difficult, right? In making a decision, it would be similar to that of buying a manual transmission car. or automatic transmission, sure enough
source: Articles by Assoc. Prof. Dr. Paraya Asanasen, Rhinomatology and Allergy Branch
Department of Otolaryngology, Nasal Larynxology, Faculty of Medicine Siriraj Hospital