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Laura Castricone, CRT

Continuous Positive Airway Pressure therapy, or CPAP therapy, is not for everyone. I have set up thousands of patients on CPAP therapy and for every successful patient, there are at least 10 others who cannot adapt to it. So, what is the recommendation for patients who have obstructive sleep apnea but do not want to, or cannot, use a PAP device?

Acknowledge Sleep Apnea and Deal with It, Before Its too Late

Why patients are unsuccessful on pep device varies from person to person. In my experience, most clients who resist therapy do not acknowledge their sleep apnea or the seriousness of it. They are either single and have no bed partner to report their snoring or have heard “horror stories” from other users about how loud or uncomfortable the machine is. And it is hard to convince our clients with bed partners that there is a problem even as it drives these couples to sleep in separate rooms - snoring, and other apnea effects such as gasping, fidgeting, leg jerks, and the like, is hard on the partner!

Ultimately, both suffer but the fact remains that not everyone will or can adapt to CPAP therapy.

What are some alternatives for PAP therapy?

Here are a few useful tips During CPAP Therapy

  • Lose weight to reduce the severity of the apnea (which correlates to excess weight)
  • Raise the head of the bed or use a bed wedge or multiple pillows
  • Avoid alcohol and any drugs that relax the airways
  • Use your inhaler before bedtime if you have asthma or COPD
  • Change your sleep position (try to avoid sleeping on your back)
  • Add a room humidifier to keep airways moisturized
  • Use Over Counter nasal strips and saline sprays (to keep nasal passages clear)
  • Explore surgical interventions (Inspire, removal of tonsils and adenoids, UPPP)
  • Explore dental devices that pull the jaw forward

Although none of these suggestions are quite the same as PAP therapy, the gold standard for the treatment of obstructive sleep apnea, they can benefit patients who cannot use a PAP device. Check with your sleep physician or health care provider on what is best for your condition.

(PS: As a concluding note, we are in the midst of a massive recall on the Philips Dreamstation One CPAP machines. The foam on their interior which is used to muffle sound and vibration, and which is a carcinogen is disintegrating and being inhaled by patients. To see if your unit is on the recall list, visit usa.philips.com and follow the instructions there.)


Author Profile: Laura Castricone, Respiratory Therapist


Laura Castricone (Certified Respiratory Therapist)

My name is Laura Castricone and I am a Certified Respiratory Therapist. I have been practicing in the state of Connecticut since 1992. I have worked in several aspects of respiratory care including sleep medicine, critical care, rehab, and home care. I earned my respiratory certification at Quinnipiac University in Hamden, CT. Prior to becoming an RT, I attended the University of Connecticut pursuing a degree in English but left Uconn in my junior year to work with my father in the restaurant business. I stayed with him for over a dozen years. An education, by the way, that can never be bought! Once I married and had children, the restaurant business no longer fit my lifestyle. When my children were one and two years old, I decided to go back to school and that is where my career in respiratory care began. This career has been very rewarding and I have been blessed to meet some extraordinary people along the way. I grew up in Waterbury, CT, and now live in Litchfield County, CT with my husband and our crazy Jack Russell terrier, Hendrix. My hobbies include antiquing, gardening, writing plays, and painting miniature paintings.



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HPFY Laura Castricone, CRT

Laura Castricone, CRT

LinkedIn Profile My name is Laura Castricone and I am a Certified Respiratory Therapist. I have been practicing in the state of Connecticut since 1992. I have worked in several aspects of respiratory ...

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