1. The working principle of sleep ventilator
When people enter a state of sleep, if the breathing command of the brain stops or the tissue of the upper airway collapses, it will cause upper air Obstruction of the tract, followed by symptoms of snoring. When using a sleep ventilator, you need to wear a mask, which is connected to the ventilator through a tube. During the treatment, the ventilator will automatically and continuously provide a certain pressure to push the air into the human body’s airway through the pipeline. At this time, the collapsed airway will be opened to control the snoring.
This mode of continuous positive airway pressure, which we call CPAP for short, is also the most important method for the treatment of snoring at home and abroad. Due to the complexity of the condition of some patients, which mode of sleep ventilator needs to be used, it is necessary to obtain the corresponding breathing mode for treatment through sleep breathing monitoring.
2. The role of home sleep ventilator
The high pressure of sleep ventilator may reduce the return blood volume, and in patients with pathological hypotension, Such as shock, extensive use of diuretics, inability to eat, and water intake, the changes in blood pressure and heart rate should be closely observed.
Digestive system: For patients with nocturnal gastroesophageal reflux, sleep ventilator can reduce the number of reflux and improve symptoms.
Urinary system: Reduces nocturnal urination in patients with osa.
Blood system: It can reduce red blood cell production and increase blood volume in osa patients, thereby reducing hemoglobin content and blood viscosity.
Neuropsychiatric system: Part or all of the memory, reaction ability, thinking ability of osa patients returned to normal.
Endocrine and metabolic system: Sleep ventilator treatment has a wide range of effects on the body’s endocrine and metabolic system, which can increase the secretion of growth hormone and male hormones, improve the sexual function of male patients, and reduce the weight of obese patients. .
The main side effects include skin breakage, contact dermatitis, and air leakage.
III. Sleep ventilator use problems and solutions
(1) Build confidence: in clinical work, patients The most frequently asked question is “Doctor, do I need to be on a ventilator for the rest of my life? Is there any other way?”. Indeed, it is inconvenient to wear a ventilator for a long time. Many doctors had doubts about it when they first started ventilator treatment, but after several years of clinical practice, doctors and patients gradually found that these doubts were unnecessary.
(2) The unsatisfactory treatment effect on the first night does not mean that the treatment fails: any new ventilator user must go through a stage of learning and adaptation before they can use it proficiently. How to wear the mask properly without leaking air, how to ensure that the nasal mask does not leak, how to clean it, how to use the delay function, etc., all need to be mastered through speculation. We often tell patients that the use of a ventilator is not a big problem. , but there are small tips, if any small link is not noticed, it will cause the treatment to fail.
Because of the memory loss and comprehension of sleep apnea syndrome patients, our experience is that even under the strict guidance of experienced doctors, the average patient needs to go through 3 nights or even longer. Only through trial and exploration can we deeply appreciate the benefits of ventilator therapy. In short, the efficacy of ventilator in the treatment of sleep apnea syndrome is certain, and the key to exerting the efficacy is how to grasp the essentials of its use as soon as possible under the guidance of experienced doctors.
(3) Treatment of air leakage from nasal mask: Air leakage from nasal mask is a common problem encountered when using a ventilator to treat sleep apnea syndrome. The most intuitive feeling of the patient is that the contact part between the nasal mask and the skin is uncomfortable due to the stimulation of cold wind. Air leakage also causes the pressure in the nasal mask to not reach the predetermined pressure, which affects the therapeutic effect. At present, the nasal mask material used in the ventilator adopts imported medical silicone, which is highly comfortable to wear and has no obvious air leakage.
(4) Dry mouth: Most patients with sleep apnea syndrome have dry mouth before treatment, which is related to long-term mouth breathing. After the ventilator is used, if it is used properly, the dry mouth will disappear naturally. There are several possibilities for causing dry mouth:
1. The pressure of the ventilator is not enough to completely overcome the obstruction of the upper airway, so mouth breathing occurs, and it is only necessary to increase the pressure of the ventilator appropriately. .
2. Too high a ventilator can also make patients feel uncomfortable and open their mouth to breathe, so the pressure should be appropriately reduced
3. Some patients are accustomed to mouth breathing, and proper drinking water can play a certain role .
(5) Nasal blockage and nasal dryness: 15% to 45% of patients will experience nasal discomfort when using a ventilator, mainly due to nasal blockage and poor ventilation. Nasal dryness. The reasons are as follows:
1. If the patient has existing nasal polyps and a deviated nasal septum, there will be nasal discomfort. The ventilator should be used after surgical correction of these deformities. Patients with severe sinusitis should also be Go to the ENT for appropriate treatment.
2. The cold air generated during the use of the ventilator can stimulate the nasal mucosa, causing vasodilation and mucosal congestion and edema. Some patients with allergic rhinitis will have acute onset. The first step is to strengthen the humidification, if necessary, add warm water in the humidification bottle, or even use a constant temperature humidifier.
3. The symptoms of dry nose can sometimes be very prominent. It is better to strengthen the humidification and warming of the inhaled air.
(6) Fear: Some patients feel very scared just after putting on a nasal mask and apply a small pressure of the ventilator, and feel uncomfortable holding their breath. This phenomenon is generally not caused by too high pressure, but a temporary discomfort phenomenon. The patient should try to adjust his state of mind, make his mind calm, and breathe according to his usual rhythm. It should be understood that a ventilator is only a breathing aid device, and the rhythm of breathing is completely controlled by the patient himself. Sometimes trying to deepen and speed up breathing in order to cooperate with the ventilator will only increase the discomfort.
(7) Automatically remove the nasal mask at night to interrupt treatment: some patients find it difficult to use the ventilator all night and unknowingly tear off the nasal mask in their sleep. This phenomenon mostly occurs during treatment. Initially, it is temporary. The common features are:
1. Obese body, serious condition, and high pressure of ventilator.
2. Discontinuation of treatment mostly occurs at 2-3 o’clock in the middle of the night.
3. Appear within 1 week after treatment.
Some patients cannot tolerate the ventilator pressure because the set ventilator pressure is too high, and the ventilator pressure should be adjusted appropriately. So when using the ventilator, if you have all kinds of troubles, you should contact your doctor more.
(8) Influence of noise: Certain noise of the ventilator, especially in the dead of night, may sometimes affect the sleep of family members and patients themselves. There are several ways to reduce the influence of noise:
1. Switch to a low-noise ventilator.
2. Some noise is generated when the breathing air is discharged through the air outlet. The small hole type exhaust valve can be replaced with a notch-shaped exhaust hole. If the inner wall of the ventilation duct is not smooth, noise can also be generated when the airflow passes through at a high speed.
3. The CPAP ventilator can be installed in a soundproof glass cover with good ventilation. Some people even put it in a closet, but make sure you have enough fresh air.
4. Wear earplugs when sleeping. What to do if the ventilator mask leaks >>
