BY DR.MANVIR BHATIA AND GARIMA SHARMA

28 May 2022, 4 Min 36 Sec read.

Obstructive sleep apnoea (OSA) is the major sleep disorder prevalent in 3 to 7% of adult men and 2 to 5% of adult women in the general population. Given all the risk factors like obesity and high neck circumference, male gender, and the older man, and others, you may have OSA that contributes to severe consequences like hypertension, heart disease, stroke, diabetes, etc.

The gold standard treatment which is proven for OSA is PAP therapy which is used during sleep. It gives positively pressurized air through a device called CPAP (Continuous positive airway pressure) which is connected to a patient with a mask via tube. This pressure keeps the airway patent and opens during sleep thus helping to stop snoring, maintaining the oxygen level, and reducing the frequent arousals due to choking or apnoea. This in return improves the daytime symptoms of fatigue, laziness, excessive daytime sleepiness, and anxiety by maintaining the daytime energy. 

WHAT IS A PAP NAP?

PAP NAP as the name suggests is a daytime trial of CPAP for making you adjust to the mask and the therapy.

WHY IS PAP NAP IMPORTANT?

As the saying goes “Practice makes the man perfect.”

Though the efficiency of CPAP therapy is proven and known, adherence to CPAP therapy is very low. PAP NAP is the supervised daytime trial with the mask and the device to make you comfortable with the interface, pressures, and a new lifestyle change and eradicate all your fears, doubts, and quarries.

This will improve the tolerance to the sleep apnoea treatment and subsequently improves the overall compliance. The therapist counsel and make you comfortable with the mask and the pressure by keeping you under close observation in the daytime while you take a nap for 30 min to 1 hour or more as required so that you can use it better at night while sleeping for more than 4 hours.

WHO NEEDS A PAP- NAP?

After going through the sleep study test, if you are diagnosed with moderate to severe obstructive sleep apnoea, you must go for CPAP therapy. Since this therapy is meant for a long term use, it’s really important for you to get adjusted to the pressure and mask, resolve your doubts regarding your issues like nose blockage, mouth dryness, claustrophobia, settings adjustment according to your need and make you comfortable with the new adjunct in your life for better compliance and sleep.

It also supports you emotionally and physically, to divert your attention from mask and pressure by giving you a daytime nap of 100 minutes.

PROCEDURE:

PAP NAP includes 5 components:

  1. Pre-test instructions to help patients take daytime naps with ease. Instructions on how to prepare for the test, like avoiding caffeine, nighttime sleep restrictions, and providing a ride to a sleep centre to avoid driving. 
  2. Introduction of PAP therapy and barrier assessment. You are given a brief idea of how the mask and pressure would feel and how to manage your fears about it and then they are assisted to try different types of masks according to your comfort and need. The mask fitting and the feel of pressure are given to you in a sitting position and you are asked to breathe normally coordinating with the air pressure coming through the mask. Once you are comfortable with the mask, you are made to lie down and try taking a nap in your usual position of sleep except for the prone position. 
  3. Emotional support. Talk about the fear, anxiety, stress, and other issues like how would the spouse react to it and the embarrassment of using a mask to sleep. All these issues are addressed one by one by the sleep therapist and reduce the anxiety. Since it’s done during regular working hours, any sudden reaction and problem can be immediately attended to and resolved by the sleep therapist.
  4. PAP NAP is conducted between 60– and 120 minutes. The primary goal is to allow you to get comfortable with the therapy and not to really do the titration part. You may or may not fall asleep but you will be able to figure out if you feel comfortable sleeping with the mask and pressure or not. 
  5. Post-test follow-up. Discussion about the PAP therapy preliminary results, motivation, adherence, and usage is then elaborated on and explained in detail on how to use the device, how to get used to it by taking daytime trials with it, how to overcome any issues related to it like bloating, mouth dryness, leakage, pressure sores, and cleaning process is done.

CONCLUSION:

Obstructive sleep apnea is becoming a major health issue among people who have loud snoring and disturbed sleep due to choking and breathing cessation, multiple times during the night. This disorder if not addressed can result in severe day and nighttime symptoms like excessive daytime sleepiness, morning headaches, and disturbing the other’s sleep as well. In long run, it may cause major health consequences like stroke, diabetes, heart attacks, etc. PAP therapy is the golden standard for the management of OSA. But the adherence to the therapy can be intimidating initially. Hence a daytime trial called PAP NAP is suggested for better compliance with the therapy and machine. It has been found that this helps in clearing all the doubts and fears of the patient in advance by desensitizing them with a mask and pressure under the close observation of a sleep therapist and thus improving your overall health. 

“Don’t hesitate, take a PAP-NAP and sleep better”

To seek help or know more about your sleep apnea, you can visit the Neurology and Sleep Centre, the 1st sleep centre in the country accredited by the Indian Board of Sleep Medicine at L-23, Hauz Khas Enclave, New Delhi, Delhi-110016 (INDIA)

Or give a call on +91-11-46070321, +91-9643500270

Book your sleep study/PAP-NAP today.

BIBLIOGRAPHY:

  1. Cao, Michelle T., Joshua M. Sternbach, and C. Guilleminault. “Continuous Positive Airway Pressure Therapy in Obstructive Sleep Apnoea: Benefits and Alternatives.” Expert Review of Respiratory Medicine 11, no. 4 (April 2017): 259–72. https://doi.org/10.1080/17476348.2017.1305893.
  2. Krakow, Barry, Victor Ulibarri, Dominic Melendrez, Shara Kikta, Laura Togami, and Patricia Haynes. “A Daytime, Abbreviated Cardio-Respiratory Sleep Study (CPT 95807–52) To Acclimate Insomnia Patients with Sleep Disordered Breathing to Positive Airway Pressure (PAP-NAP).” Journal of Clinical Sleep Medicine 04, no. 03 (June 15, 2008): 212–22. https://doi.org/10.5664/jcsm.27183.
  3. Punjabi, Naresh M. “The Epidemiology of Adult Obstructive Sleep Apnea.” Proceedings of the American Thoracic Society 5, no. 2 (February 15, 2008): 136–43. https://doi.org/10.1513/pats.200709-155MG.
  4. “What Is a PAP-NAP?” Accessed March 28, 2022. https://www.sleepassociation.org/sleep-apnea/what-is-a-pap-nap/.

[1] Naresh M. Punjabi, “The Epidemiology of Adult Obstructive Sleep Apnoea,” Proceedings of the American Thoracic Society 5, no. 2 (February 15, 2008): 136–43, https://doi.org/10.1513/pats.200709-155MG.

[2] Michelle T. Cao, Joshua M. Sternbach, and C. Guilleminault, “Continuous Positive Airway Pressure Therapy in Obstructive Sleep Apnoea: Benefits and Alternatives,” Expert Review of Respiratory Medicine 11, no. 4 (April 2017): 259–72, https://doi.org/10.1080/17476348.2017.1305893.

[3] “What Is a PAP-NAP?” accessed March 28, 2022, https://www.sleepassociation.org/sleep-apnea/what-is-a-pap-nap/.

[4] Barry Krakow et al., “A Daytime, Abbreviated Cardio-Respiratory Sleep Study (CPT 95807–52) To Acclimate Insomnia Patients with Sleep Disordered Breathing to Positive Airway Pressure (PAP-NAP),” Journal of Clinical Sleep Medicine 04, no. 03 (June 15, 2008): 212–22, https://doi.org/10.5664/jcsm.27183.

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