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Laura Castricone

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 PAP therapy 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 and follow the instructions there.)


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HPFY Laura Castricone

Laura Castricone

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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 ...

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