CPAP is a small device used in respiratory failure and snoring. In addition, it is one of the most effective tools for treating obstructive sleep apnea. It is a safe alternative to pharmacological therapy and surgeries correcting anatomical defects of the upper respiratory tract, and the positive effects of its use are often noticeable from the very first use.
The biggest advantages of CPAP therapy are:
The mechanism of the CPAP machine is quite simple. In people with sleep apnea, the throat and tongue partially collapse during sleep, leading to snoring and apnea. Thanks to CPAP, air under constant positive pressure is supplied directly to the patient’s respiratory tract, which keeps the tongue and throat in the correct position, preventing them from collapsing. This keeps the airways open and episodes of apnea stop.
To receive a refund for CPAP from the National Health Fund, the following entitles:
“Order for the supply of medical devices being orthopedic devices and auxiliaries”.
The order, after receiving it from the doctor, should be confirmed at the NHF branch. Each patient is entitled to a refund for the CPAP device once every 5 years and amounts to PLN 1,890, i.e. 90% of the NHF limit, which is PLN 2,100.00.
NHF facilities http://www.nfz.gov.pl/kontakt/oddzialy-nfz/
The path to apply for PCPR / MOPS funding
You can also apply for funding from other institutions:
State Fund for Rehabilitation of Disabled Persons https://www.pfron.org.pl/kontakt/
County Family Support Center http://www.pcpr.info/
Social Welfare Centers https://ops.pl/strony-ops-ow/
Medical equipment issuing point https://www.google.pl/maps/place/Ewy+1,+03-641+Warszawafirstname.lastname@example.org,21.0562056,17z/data=!3m1!4b1!4m5!3m4!1s0x471ece95dcd34fad:0x71341960b8fc05a1b8fc05a1b8fc ! 8m2! 3d52.290662! 4d21.058405
Although in Poland the purchase of a CPAP device is partially reimbursed by the National Health Fund, not many people can afford such an expense. In addition, each patient has a different tolerance to the use of airborne prostheses and it may always turn out that this form of treatment causes him discomfort, preventing effective therapy.
Here, a good solution is to rent. CPAP devices improve the quality of life and sometimes even save it. If you also suffer from obstructive sleep apnea, you should definitely get your CPAP. However, if you are not sure about its operation and you do not want to buy the equipment immediately for the full amount, we offer the perfect solution to this situation. In the new rental shop on respiratory.pl, you can try the device prescribed by your doctor and, on this basis, decide whether to buy it permanently or to change the equipment. It is also a great solution for people who wait for the release of a new hearing aid, e.g. after a complaint, and do not want to stop the treatment. For hygiene reasons, it is only necessary to purchase a suitable mask, which will be useful in the future with regular CPAP purchases. You will get the equipment already programmed according to the doctor’s recommendations and ready for use.
Link to the rental on the respiratory system http://www.oddechowy.pl/index.php/wypozyczalnia-aparatow-cpap.
OBSTURATIVE SLEEP APNEA
A lot of people snore, some of them so loudly that it may disturb others. This is called “asocial snoring” and can be a symptom of the disorder of sleep breathing – Obstructive Sleep Apnea Syndrome (OSAS).
Despite the growing interest, in Poland this disease is still little known and underestimated, both by patients and a number of doctors who may have contact with people affected by these disorders. This is especially important for two reasons:
Untreated breathing disorders during sleep can cause or exacerbate the course of other diseases, including hypertension, ischemic heart disease (the so-called coronary disease). They may also be responsible for more frequent strokes. Untreated people with OSA of a significant degree, due to significant drowsiness, a feeling of constant fatigue, lack of sleep, are unable to function normally. It is also extremely important that patients with OSA may be the perpetrators of traffic accidents due to falling asleep at the wheel much more often than others.
Basic information on the prevalence of breathing disorders during sleep.
Disorders of breathing during sleep as a separate disease entity – OSA and OSA or OSAS appeared in the second half of the last century. However, if you look closely at the belles-lettres, already in the case of Dionysios of Heraklea, who lived in the 4th century BC, one would suspect the existence of OBPS. Greed led Dionysius to unprecedented obesity and daytime sleepiness, and to wake him from deep sleep, doctors used long needles inserted into the skin of his abdomen or chest. King Magas, described by Athenae in 258 BCE, suffered similar ailments. For many years, patients with a high degree of obesity and daytime sleepiness are commonly referred to as Pickwick’s syndrome. The literary prototype of such a character is Joe – the stable boy, from the novel “Pickwick’s Club” by Charles Dickens. He was an obese boy who was snoring extremely loudly, and he was able to fall asleep even while standing.
In the medical literature, you can find a lot of studies analyzing the incidence of breathing disorders during sleep. It seems, however, that the most valuable is the analysis by the authors at the University of Wisconsin. Prof. T. Young and colleagues, conducting research on a group of 602 people aged between 30 and 60 years, showed that 2% of women and 4% of men can be diagnosed with OSA. If we take into account the number of inhabitants of Poland, it can be expected that there are currently around 450,000 in Poland. people affected by these problems. Even if one accepts the existence of fundamental differences between the American and Polish populations (resulting, for example, from a different incidence of obesity), it is a lot. The sheer number of patients with these disorders is very large, it is also necessary to realize that there is no indication that this problem could be solved or even reduced in the near future. Studies on OSA patients have been conducted in our country for a little over 10 years, until quite recently, the largest number of patients across the country was seen in two laboratories: one at the Institute of Tuberculosis and Lung Diseases, and the other at the Pneumonology Clinic of the Medical University, both centers operating in the area of Of Warsaw. These are undoubtedly the centers with the greatest experience in this field, starting from the first half of the 1990s, new centers dealing with the diagnosis and treatment of OSA have developed, and now patients living also in Wrocław, Katowice, Bydgoszcz, Poznań, Lubin have easier access to diagnostics and treatment in suspected breathing disorders during sleep.
Why do some people stop breathing at night?
OSA is a disease in which breathing interruptions occur during sleep, known as apnea. According to the medical definition, apnea is when there is no flow through the airways. The immediate cause of apnea in OSAS patients is the collapse of the soft parts of the throat; the patient’s soft palate collapses, the tongue retracts into the throat, and other parts of the throat may also collapse. The end result is initially a reduction and then complete closure of the lumen of this section of the airways, which is manifested by apnea. Despite many studies conducted so far, it has not been possible to clearly establish the cause that leads to the development of disorders. First of all, 2 groups of factors are taken into account:
Sleep apnea is not always a symptom of the disease, and may also occur in small numbers in healthy people. In order to distinguish normal from disease, the so-called Apnea Index (AI) is calculated, this is the number of apnea per hour of sleep. It is believed that in healthy people it can have a maximum value of 10; which means healthy people can have up to 10 apnea per hour of sleep. It happens, however, in patients that even 400 or 500 apnea are registered during one night. If the duration of particular disorders is given, it is often found that the person does not breathe at all for more than half the sleep time. The duration of the apnea varies, on average it is between 20 and 30 seconds, although apneas lasting even 2-2.5 minutes are noted.
What are the consequences of apnea?
Due to the closure of the airways, one of the most important functions of the respiratory system, air exchange in the lungs, is disturbed. During apnea, the oxygen content is lowered, and thus all organs are hypoxic, including those most sensitive to the reduction of oxygen in the blood, i.e. the brain, heart, kidneys, and liver. A very useful indicator of the oxygenation of the body is the saturation of arterial blood with oxygen: saturation (SaO2). In healthy people, SaO2 is usually in the range of 95-98%, while during apnea, depending, among other things, on its duration, a reduction of SaO2 to less than 50% or even 40% is often observed. To illustrate how serious these disorders are, it can be said that if a healthy person was suddenly moved to the top of Mount Everest, the measured SaO2 value would be about 50%. It should also be noted that at such a high altitude (8,848 m a.s.l.) none of the climbers can climb without a long period of adaptation to high mountain conditions and very few people entered it without the help of an oxygen mask.
In addition to lowering the oxygen content in the blood, a number of other abnormalities occur during apnea: blood pressure rises (systolic pressure may exceed 200 mmHg!), Heart rhythm disturbances occur.
Each apnea must end at some point. It comes about as a result of awakening; the patient wakes up for a period of several seconds, awakening is associated with an increase in muscle tension – the upper respiratory tract opens, the patient takes a few breaths, takes a few breaths, then falls asleep again and in a moment another apnea begins. On the one hand, awakenings play a defensive role – they prevent the patient from suffocating during sleep, but on the other hand, it is difficult to expect a person who wakes up several hundred times each night to be able to function normally during the day. Repeated awakenings after many times lead to the breakdown of the normal structure of sleep, i.e. changes in the duration of individual sleep phases that do not condition adequate rest. In patients with OSA, the duration of deep sleep and REM sleep (fast eye movement sleep – the phase of sleep in which dreams occur) is shortened.
Ailments and symptoms related to breathing disorders during sleep
For easier description, the ailments and symptoms of OSA are divided into those occurring during sleep and during the day. It turns out, however, that the most important problem for patients are the ailments they feel during the day, while the patient’s immediate environment is the most complainant about what happens to the patient during sleep.
From a pathophysiological point of view, the snoring sound is produced mainly during the inhalation phase, as a result of vibrating the soft, structures of the upper respiratory tract, devoid of bone or cartilage support. Contrary to previous opinions, the formation of these sounds may involve not only the soft palate and the uvula, but also other elements of the upper respiratory tract – up to the level of the vocal cords. Such a complex etiology, the participation of many different elements means that the development of an effective method of eliminating this ailment is still a huge challenge for medicine. The fact that snoring has been common for a long time, however, an accurate assessment of the frequency of this phenomenon is very difficult. The data from the literature are broadly divergent: 5 to over 80% of men and 2-57% of women are thought to snore regularly. Snoring is an inherent symptom associated with OSA. In highly advanced cases, the patient snores regardless of the sleeping position: sitting, on the stomach, on the back or on one side. Exceptionally loud and irregular snoring is typical of breathing disorders during sleep. It happens, however, that in the initial stage of the disease, snoring disappears or decreases in intensity while sleeping on the stomach or side. Snoring sounds, on the other hand, are significantly intensified after drinking alcohol or taking sleeping pills. They are often so loud that sick spouses are not able to stand either in one bed or even in one room – unfortunately, snoring can also cause serious family problems. Snorers are the bane of holiday or business trips and can astonish or even scare your travel companions by bus, train or plane. Irregular snoring in patients with OSA is associated with periods of apnea – when there is no air flow through the respiratory tract, snoring sounds are also not audible; very loud, even dramatic sounds appear on awakening.
SYMPTOMS APPEARING DURING THE DAY
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