EPAP! Ever hear of it? I’m guessing you did or you wouldn’t be here. Now you’re wondering what is EPAP and how does it work? You may also be wondering if it’s a good option for you.
EPAP (nasal expiratory positive airway pressure) is a treatment for obstructive sleep apnea (OSA) and snoring.
OSA is a potentially dangerous condition that causes you to stop breathing for short periods of time while sleeping. These periods are known as apneas and some OSA sufferers have up to 30 apneas per hour.
Apneas are highly undesirable. They interfere with sleep, raise blood pressure, affect the mood, and can be the catalyst for potentially fatal problems such as strokes and cardiovascular disease.
The condition also causes snoring but, given the other issues it presents, snoring is a pretty tame symptom.
What Will I Learn?
How Does EPAP Work?
The reasons behind OSA’s ability to interfere with breathing and initiate snoring are one and the same. It can be summed up in two words: Airway obstruction.
When we go to sleep the muscles and tissue at the back of the throat relaxes and the tongue tends to drop back in the mouth. This interferes with normal respiration and airflow.
While the obstruction remains partial the air passing through the throat causes the flesh to vibrate. This results in the audible disturbance we call snoring.
When the obstruction becomes worse, normal breathing stops and our inbuilt survival instinct causes us to wake, often gasping for breath. It’s not unknown for apneas to cause choking as well.
EPAP works by increasing the pressure in the airways. This helps keep things clear, encourages normal breathing and also prevents snoring.
CPAP machines work in a similar way but provide the necessary pressure increase in a different way.
Nasal EPAP Device Vs. CPAP Machine: What’s the Difference?
So, what’s the difference between these two popular OSA treatments? Let’s begin with CPAP machines first.
CPAP (continuous positive airway pressure) is by far the more commonly-used treatment. The CPAP machine draws in air, pressurizes it, and then pumps it to a face mask via a special tube.
With CPAP, the pressure remains constant. Regardless of whether you are inhaling or exhaling the pressure is there. Its presence pressurizes the airways sufficiently to keep them open. This prevents apneas and snoring.
With EPAP devices, the pressurization is not constant. It’s only present during the exhale.
Before going to sleep, you place the EPAP device in the nostrils. The device contains two sophisticated 2-way valves—one for each nostril.
When you inhale, the valves open to enable normal breathing. Because the inserts tend to expand the nostrils slightly, the intake of breath may actually be superior to normal.
Things change when you attempt to exhale. The valves open the other way, but not fully. This restricts airflow when you are breathing out.
The restriction is not that great but it’s enough to increase the amount of pressure needed to expel the breath. As with CPAP machines, the pressure is the important thing.
The History of EPAP Devices
EPAP technology was invented by Rajiv Doshi. He was both a doctor and an engineer. He developed his prototype EPAP device for his wife, who’d asked him to help her stop snoring.
His idea was inspired by an incident he’d witnessed at medical school during the 1990s. An emphysema patient was doing some breathing exercises through pursed lips. The exercise alleviated the symptoms by creating a back pressure that forced her airway open.
Doshi’s original attempts to make an EPAP device involved various types of tubing and small pieces of latex glove. His finished product was eventually brought to market under the Provent brand name.
The Advantages of EPAP Devices
Unlike CPAP machines, EPAP devices are very small and portable. They do not need a power supply and there are no real maintenance needs.
Some experts also argue EPAP devices are better than CPAP machines because the pressure is not forced on the body by a machine. It’s created by the device wearer instead, which could be seen as a more natural way to go.
EPAP devices are also more comfortable to use than mandibular advancement devices and tongue stabilizers. The general ease of use, along with the level of comfort, is a strong selling feature in itself.
If you are searching for an anti-snoring method that’s less invasive than a mandibular advancement device or tongue stabilizer, an EPAP device may be a good first point of call.
The technology may also be a viable alternative to a CPAP machine. Nevertheless, EPAP requires further study. It’s far from being a science-backed treatment for snoring. Yet many people have enjoyed great success using this type of anti-snoring device.
However, although an EPAP device may offer value if you are a mouth snorer, it’s unlikely to offer much benefit to you if you are a nose snorer.
EPAP devices are also a poor option for anyone who has nasal obstructions that make nose breathing difficult.
EPAP Device Pros and Cons
- Works well for some people
- Highly portable technology
- Less invasive than some other options
- Does not require electricity to make it work
- Little risk of side effects
- New technology that requires further study
- Doesn’t work for people who have difficulty with nose breathing
- Will be ineffective if you sleep with your mouth open