A Continuous Positive Airway Pressure (CPAP) machine is used for the treatment of sleep apnea.  Obstructive sleep apnea occurs when the upper airway becomes narrow as the muscles relax naturally during sleep. This reduces oxygen in the blood and causes arousal from sleep. The CPAP machine stops this phenomenon by delivering a stream of compressed air via a hose to a nasal pillow, nose mask or full-face mask, splinting the airway (keeping it open under air pressure) so that unobstructed breathing becomes possible, reducing and/or preventing apneas and hypopneas. This has the additional benefit of reducing or eliminating the extremely loud snoring that sometimes accompanies sleep apnea.

The CPAP machine blows air at a prescribed pressure (also called the titrated pressure). The necessary pressure is determined by a sleep physician after review of a sleep study supervised by a sleep technician during an overnight study (polysomnography) in the sleep center. The titrated pressure is the pressure of air at which most (if not all) apneas and hypopneas have been prevented, and it is usually measured in centimeters of water (cm H₂O). The pressure required by most patients with sleep apnea ranges between 6 and 14 cm H₂O. A typical CPAP machine can deliver pressures between 4 and 20 cm H₂O. More specialized units can deliver pressures up to 25 or 30 cm H₂O.

CPAP treatment can be highly effective in treatment of obstructive sleep apnea.  For some patients, the improvement in the quality of sleep and quality of life due to CPAP treatment will be noticed after a single night's use. Often, the patient's sleep partner also benefits from markedly improved sleep quality, due to the elimination of the patient's loud snoring.

CPAP machines and equipment are provided to the patient by a home medical equipment company.  Pulmonary Medicine Associates will order the CPAP machine for you from one of the home medical equipment companies.  You have a choice which home medical equipment company to use but we will recommend the company that is contracted with your insurance. 

Follow-up with a PMA physician is required to keep your CPAP machine.  You must come in and see one of our physicians between the second and third month of using CPAP to report that it is working in order for some insurance companies to continue paying for the machine.  We will schedule this appointment with you when we order the CPAP machine for you.

Given that sleep apnea is a chronic health issue and usually doesn't go away, ongoing care is needed to maintain CPAP therapy. The physicians and staff of PMA are dedicated to providing ongoing help and support with your CPAP treatment.  

CPAP Problems, FAQs, and Support

Many people have difficulty tolerating or adjusting to CPAP therapy.  There are many options available to help.  Please be very upfront and honest about how you feel about the therapy and equipment with your physician and during your titration sleep study.  The physicians and technologists at PMA Sleep Center will help you adjust to CPAP therapy and be able to use is regularly.  For a list of common problems and resolutions as well as frequently asked questions and support click here.

Types of CPAP

There are a few different types of CPAP. The term CPAP is a general term used to describe all types of Positive Airway Pressure (PAP) therapy  but is also a specific type of PAP.  CPAP is the most common type of PAP and consists of one constant pressure blowing to keep the airway open. 

Another common type of PAP is one that uses two different pressures - a higher pressure during inhalation and a lower pressure during exhalation.  This type is called BiPAP or Bi-Level.  BiPAP is most commonly used for patients who have difficulty exhaling against a high CPAP pressure.  It may also be used for certain types of sleep apnea or other breathing problems.

Sometimes a BiPAP machine with a backup rate is used to help patients breath when they have a certain type of sleep apnea called central sleep apnea.  The backup rate tells the machine to switch between the inspiratory pressure and expiratory pressure at a set rate to encourage the breathing. 

A new type of CPAP called Servo Ventilation may also be used.  This is highly specialized machine that self-adjusts to keep patients breathing at or above a specific target level.  This type of machine is used for patients with Central Sleep Apnea or Cheyne-Stokes Respiration.

The last type of PAP is called AutoPAP.  This is actually a specific type of CPAP machine that self adjusts the CPAP level to resolve apneas.  This type of machine is useful for patients who have worse apnea in different stages of sleep or in different positions (like when on their back) and have difficulty tolerating higher CPAP pressures.  These machines can also be used as a diagnostic tool to see if the pressure a patient is on at home should be set higher.

The type of machine used will depend on what type of sleep apnea the patient has and the patient's response to therapy.  The physician will use the data collected during the titration sleep study and discuss the options with the patient to decide what type of PAP therapy to prescribe.  Occasionally an extra sleep study may be needed to try a different type of therapy. 

The CPAP Machine

Today's CPAP machines are very small and quiet.  There are several different brands of CPAP machines.  We can help you determine the best machine for your needs.

The CPAP Mask

There are also many different kinds of CPAP masks available.  The technicians at the sleep center will work with you to find the mask that will work best for you during your sleep study.  You may also be refitted for a different mask if you are having problems with your mask.  This should be done within 30 days of receiving your mask if possible as your DME company can switch your mask for free.  

Pulmonary Medicine Associates Sleep Center has specially trained staff who are very knowledgeable of all the masks available.  We have all of the masks available at our sleep center so that we can find one that works for you during your sleep study and we can also refit you for a mask and provide a prescription for a new mask.  We can also help with other issues involved with using your CPAP.  It is important to continue follow-up with the physician so we can help you to use your CPAP.  We are dedicated to providing ongoing help and support with your CPAP treatment.