President Joe Biden has begun using a CPAP machine for the underdiagnosed disorder obstructive sleep apnea, or OSA.
White House spokesman Andrew Bates told reporters on Wednesday that Biden was diagnosed with the disorder in 2008, and sources close to the president confirm that he started using the machine to improve sleep quality.
Medical experts estimate that there are 20 million Americans with OSA, but the disorder is significantly underdiagnosed. More than 8 million of those diagnosed with the disorder use CPAP.
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What is OSA?
OSA occurs when a blockage in the airway prevents the patient from breathing while sleeping, causing the patient’s blood-oxygen levels to drop. This pattern, medically known as an apneic episode, triggers a “survival reflex” in the brain, causing the patient to wake up in order to respond to the emergency and begin breathing.
Johns Hopkins Medicine classifies OSA as a patient having at least five apneic episodes per hour that last at least 10 seconds each. Patients with mild OSA experience 5-15 apneic episodes per hour, while those with more than 15 are considered moderate and those with greater than 30 are severe.
Who is at risk?
Those with a neck circumference larger than 17 inches or structural anomalies, such as a deviated septum or enlarged tonsils, are at a greater risk of developing OSA because of the physical shape of the airway. Obesity, Type 2 diabetes, and age are also comorbidities of OSA.
Although the disorder often goes undiagnosed, the primary diagnostic symptom of the disorder is daytime sleepiness, along with observed apneic episodes or waking up gasping during the night. Other symptoms include loud snoring, headaches, mood changes, and difficulty concentrating.
Patients with severe OSA can have hundreds of apneic episodes in one night, increasing the patient’s risk for high blood pressure, heart disease, and strokes.
What is CPAP?
CPAP, or continuous positive airway pressure, machines are devices that deliver pressurized oxygen through tubing in a mask that a patient wears during sleep, allowing for continuous airflow.
There are a variety of machines and mask types that operate differently depending on the patient’s sleep habits and the severity of the disorder.
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The American Academy of Sleep Medicine recognizes CPAP as the first-line treatment for moderate to severe OSA, though patients often find using the machine difficult and do not use it as consistently as prescribed. Although the machine is supposed to be worn constantly throughout the sleep cycle, medical compliance is often deemed sufficient if the patient wears the machine for four hours during a night.
CPAP devices are classified by the Food and Drug Administration as having possible risks and therefore require a medical prescription.
Mild OSA can be treated with oral appliances that manipulate the jaw and palate to keep the patient’s airways unobstructed. Oral devices also require a prescription.
