A Look Back at the History of CPAP Therapy
Today, CPAP therapy is more common than ever before. An increasing number of medical professionals and patients are coming to recognize the many ways that using a CPAP machine can improve their well-being.
After all, the benefits of a CPAP device go far beyond just getting a good night’s sleep. Treatment compliance can help individuals who suffer from sleep apnea avoid or mitigate many of the complications that can result from this condition, including depression and heart disease.
With a seemingly endless selection of CPAP and BiPAP machines to choose from, it is easier than ever for patients to get the help they need. But it hasn’t always been this way. Here is a closer look at who CPAP treatment came to be, as well as the advances that have been made over the years.
In the Beginning
Research has found that approximately 24 percent of middle-aged men and nine percent of middle-aged women suffer from obstructive sleep apnea, making this condition surprisingly common. Despite this, sleep apnea was not discovered until 1965. Early on, the condition was only associated with people who had extreme symptoms, typically connected with conditions such as obesity, congestive heart failure, and hypoxemia.
While medical professionals were quick to recognize that obstructive sleep apnea was the result of intermittent closures of the windpipe, it was many years before the idea of applying positive airway pressure came to light.
In fact, in these early days, tracheostomy (also known as a tracheotomy) was viewed as the only effective solution for sleep apnea. Needless to say, the idea of having a breathing tube placed into the windpipe was hardly appealing. A tracheostomy makes it hard to speak and swallow, and the breathing tube typically needs to be cleaned several times each day to prevent blockages from mucus or fluid. This is why it is typically only used as a last resort with other breathing conditions or during an emergency situation.
The lasting inconveniences of the surgery meant that for many, getting “treatment” would ultimately create more problems than it solved.
The real breakthrough in sleep apnea treatment didn’t occur until June 1980, when Dr. Colin Sullivan and his team tested the use of positive air pressure in treating the sleep disorder. The first test was performed on a patient who had refused a tracheotomy for addressing his severe sleep apnea.
As Dr. Sullivan recalled in an interview with the National Sleep Foundation,
“We put together the breathing circuit in the afternoon, and then used plastic tubes and a rapid setting silicone sealant to provide access to the nasal airway. Within minutes of the full polysomnography (PSG) set-up, the patient had gone to sleep and developed repetitive severe sleep apnea. I gradually increased the air pressure in the circuit, and then suddenly the apnea stopped and normal breathing appeared. It was an incredible result. As we watched in amazement, the patient went into REM sleep. I quickly decided to repeat the experiment by dropping the pressure and the apnea recurred.
“I went through a series of cycles increasing the pressure and so literally ‘turning off’ the apnea, and then dropping the pressure and ‘turning on’ the apnea. There was no uncertainty or ambiguity. The method worked. The effect was so clear and repeatable, the next question to answer was would it work all night? Could we use it as a treatment? We decided to leave the patient on the pressure for the rest of the night. We watched as he continued to sleep for around 7 hours, without any apnea, and with the most extraordinarily intense sleep patterns. The patient’s response the next day was equally exciting. He was awake and alert for the first time in years.”
This experiment marked a key turning point in the treatment of sleep apnea. In a single experiment, Dr. Sullivan and his team had proven that delivering continuous air pressure to an individual’s breathing passages can prevent instances of sleep apnea, allowing patients to enjoy the quality sleep that so many other people take for granted.
After this initial discovery, Dr. Sullivan and his team continued their work in earnest. After all, it was one thing to treat a patient in a laboratory setting, but it would be quite another to ensure that individuals could receive sleep apnea therapy in their own home. The early experimental CPAP models used vacuum cleaner fans with inlet and outlet tubes — hardly the ideal solution for at-home use.
It wasn’t until 1985 that the first commercial CPAP machines were introduced by Respironics (now known as Philips Respironics) — a brand that continues to be well-known in the CPAP market today. By this point, a little over 100 people were attempting sleep apnea treatment at home, with Dr. Sullivan and his team still closely involved in tracking the therapy outcomes of the majority of these individuals.
Interestingly, the researchers viewed their newly-developed CPAP devices as a temporary solution, something to help patients manage their condition until a permanent cure was found. Dr. Sullivan believed that an improved surgical technique or medication would be developed to eliminate the need for CPAP devices. For better or worse, such a “permanent cure” still hasn’t materialized to this day. However, researchers and manufacturers are continuing to innovate with new and better CPAP machines that make it easier for patients to take control of their sleep habits.
In 1990, the self-sealing mask, sometimes referred to as the “bubble mask” was invented. Not only did this improve patient comfort, but it also helped mitigate air leaks during treatment. Preventing air leaks helps patients avoid skin irritation while also ensuring that enough air pressure is delivered throughout the night.
The 1990s were an important decade for sleep apnea innovations. In 1992, Respironics patented “bi-level technology” — a noteworthy CPAP improvement that led to the introduction of BiPAP machines. By reducing how much air pressure is delivered during exhalation, BiPAP machines are able to improve comfort and treatment compliance among patients who find standard CPAP treatment to be too uncomfortable. BiPAP has since been found to also be effective in addressing chronic obstructive pulmonary disease (COPD).
Subsequent developments largely built upon these important advances. A wider variety of CPAP masks have been introduced with styles including full face masks, nasal masks, and nasal pillows. Today’s masks are designed for enhanced comfort and better adherence to the skin to prevent leaks. Specialty sizes for women have also been introduced to help meet the needs of a previously underserved group.
Building off the introduction of BiPAP equipment, many CPAP manufacturers have since developed auto-adjusting machines. These machines monitor a patient’s breathing patterns throughout the night, adjusting pressure delivery with each breath to effectively prevent sleep apnea episodes while also maximizing comfort.
Other key developments include auto ramping features, which gradually increase pressure delivery while the patient falls asleep, automated monitoring of a patient’s treatment, and even reduced noise levels. Portable travel-sized CPAP machines are also available so patients never miss a night of therapy.
All of these advances have helped make CPAP therapy more convenient, comfortable, and effective than ever before. As a result, over one million people in the United States are now able to get the help they need through sleep apnea therapy.
Understanding the Importance of Treatment
Alongside the ever-advancing equipment used in CPAP therapy, additional studies have shed further light on just how important this treatment is. After Dr. Sullivan’s initial experiment, patients would adopt CPAP treatment because it helped them feel well-rested in the morning so they could function better during the day.
It was only in future years that the more significant long-term consequences of sleep apnea were discovered. Continued study of the condition has helped doctors recognize a wide range of issues connected with sleep apnea, including diabetes, heart disease, liver function impairment, depression, and irritability. Not surprisingly, increased drowsiness during the day has also been linked to a greater risk for driving and work accidents.
An improved understanding of sleep apnea has also made it easier to identify the symptoms and risk factors associated with the disorder. For example, people who are obese, have a large neck circumference, small jaw bone, or deviated septum are more likely to develop the condition. Research has also found a connection between alcohol and tobacco consumption and sleep apnea, further illustrating the importance of avoiding such substances.
As awareness of sleep apnea has grown, specialized testing facilities have become more commonplace. At these locations, patients can undergo a formal sleep study to determine the frequency of sleep apnea incidents. Improved monitoring equipment allows doctors to identify how many sleep apnea events a patient experiences each hour, making it easy to determine when treatment is needed.
Today, severe obstructive sleep apnea is defined as having over 30 incidents per hour — in other words, experiencing a sleep apnea event at least every two minutes. Classification as mild, moderate, or severe helps medical professionals determine what pressure settings are needed to help a patient manage their condition.
What Does the Future Hold?
While the search for a “cure” for sleep apnea will undoubtedly continue in the years to come, Dr. Sullivan and other industry leaders expect CPAP therapy to remain the go-to resource for addressing sleep apnea. As such, you can expect researchers and equipment manufacturers to continue to look into ways to make treatment more effective and comfortable than in the past.
This doesn’t mean that future developments will only be focused on making minimal improvements. In the previously cited interview, Dr. Sullivan noted that his team was engaged in research for groups that are commonly overlooked in sleep apnea treatment and studies: children and infants who experience obstructed breathing, and women who develop sleep disorders during pregnancy.
As Dr. Sullivan noted, “Sleep disordered breathing in childhood is probably very instrumental in delaying or damaging cognitive development, [while] we showed several years ago that women with pre-eclampsia develop obstructed breathing in the third trimester [of pregnancy] and that it triggers a large rise in arterial blood pressure in sleep.”
It is clear that sleep apnea can have significant negative side effects for these groups, yet effective treatment remains elusive. Thankfully, research is being done to ensure that these underserved populations also receive needed help for their sleep apnea.
As a result, don’t be surprised if future industry developments focus on helping people who fall outside the “standard” sleep apnea model improve their treatment options.
You should also expect increased efforts at improving awareness for sleep apnea. The American Sleep Apnea Association reports that 80 percent of individuals who suffer from moderate to severe sleep apnea don’t receive a diagnosis for their condition. This is largely due to a lack of awareness that drowsiness, snoring, and morning headaches can indicate the presence of this sleep disorder.
The future of CPAP doesn’t merely involve improved equipment and better understanding of sleep apnea. It will also depend on the medical community’s ability to increase awareness of this sleep disorder and help people understand just how important it is to seek treatment.
While sleep apnea treatment has progressed significantly over the years, challenges still remain for many who suffer from this condition. CPAP equipment can prove quite costly, particularly for those who don’t have insurance, or whose insurance policies don’t provide adequate coverage for sleep apnea treatment.
All the CPAP advances in the world won’t do you any good if you don’t have access to the equipment you need. That’s why at Help Medical Supplies, we offer significant discounts on CPAP machines, masks, and other essential parts. With free shipping on orders over $89 and available financing, our team is going the extra mile to help you afford quality CPAP machines.
You don’t have to continue suffering from the effects of sleep apnea. With affordable solutions for purchasing your own CPAP equipment, Help Medical Supplies is ready to help you take advantage of this relatively recent medical development so you can get the quality sleep that leads to a better overall well-being.