Individuals with Down syndrome are more susceptible to obstructive sleep apnea. Their upper airways are usually smaller because of a larger tongue and smaller maxilla (upper jaw). Other factors can contribute to a narrower airway passage such as lower muscle tone, obesity, enlarged tonsils, and hypothyroidism. To learn more about sleep apnea please refer to the Sleep Apnea handout on the Resources page on the ADSC website.
We will discuss CPAP and tips for successful usage. CPAP stands for continuous positive airway pressure. It is given by a machine which blows air into the upper airways at a pre-set constant pressure. The machine is attached by an air hose to a mask worn on the face while sleeping. The positive pressure expands the upper airway and prevents its collapse. The optimal pressure setting is identified during a titration (adjustment) study, during which different pressures are trialed to determine the lowest pressure needed to prevent obstruction. While CPAP can seem cumbersome at first, most people successfully adapt to it, and learn to associate wearing it with feeling better during the day.
There are 3 parts to the CPAP machine; the motor, the hose, and the mask. The motor takes room air and pressurizes it to deliver the perfect amount of air pressure you need to clear the obstruction. The hose simply delivers the air from the motor to the mask. The mask comes in all shapes and sizes to help the individual feel comfortable wearing the mask.
There are 3 different types of masks – nasal pillow, nasal mask, and full-face mask. The nasal pillow, the smallest, only enters the nostrils. It allows users to wear their glasses and is good for active sleepers who toss and turn a lot but not ideal for mouth breathers. The nasal mask is triangular and fits over the nose. It is better for higher pressure settings and allows more natural airflow than the pillow. They once again are not ideal for mouth-breathers or those who experience allergies and significant nasal congestion. The full-face mask covers the nose and mouth. This is ideal for mouth breathers and those who have nasal obstruction or congestion.
Tips and Tricks for CPAP
To help get comfortable wearing the mask, begin using the CPAP for short periods during the day when relaxing or watching TV. This will help your family member become comfortable with using the mask and help it feel more natural when falling asleep at night.
Make CPAP part of your bedtime routine. As we know, our individuals with Down syndrome like to have routine in their lives. Adding CPAP to the nighttime routine will help it feel more natural while helping them feel more rested in the morning and have more energy during the daytime!
Make small adjustments until it is just right. Making small adjustments at home with the straps and the headgear can help it be more comfortable. See which mask type is most comfortable for getting the best sleep.
The highest number of problems occur when the mask does not fit correctly. If the mask is too small it will not seal properly and air can leak out the side and blow into your eyes.
If you are having nasal congestion this may be from your CPAP. You can use a saline nasal spray or decongestant to help. Please discuss with your healthcare provider prior to starting any decongestants or antihistamines.
CPAP can cause you to have a dry mouth, throat, or nose. Many devices have a heated humidifier to help you breathe warm, moist air through your mask.
If any of these tips do not work, please contact your sleep center or your health care provider.