If you’re considering adding a CPAP machine to your nightly routine, then you may have several questions—ranging from how do I know if I have Obstructive Sleep Apnea (OSA), how do I get a CPAP machine, what is a CPAP anyway, how does a CPAP machine work, and what kind of machine should you get?
Some of the first few questions you’re likely to ask are “what exactly is sleep apnea and how do I know if I have it?” OSA is one of the three types of sleep apnea. The others include Central Sleep Apnea (CSA) and Complex (mixed) Sleep Apnea.
What Is CPAP Therapy and How Does It Work?
Your next questions are likely, “what is CPAP therapy and why do I need it?” or “what does a CPAP machine do?”
CPAP stands for continuous positive airway pressure and is the term for a machine used to treat mild, moderate, or severe sleep apnea. A CPAP machine (sometimes referred to as a (sleep apnea machine) is a medical device that can be prescribed by a board-certified sleep specialist or your primary care physician.
Your CPAP machine provides a constant, gentle flow of pressurized air that keeps your airway from collapsing while you sleep. This helps you breathe and maintain good blood oxygen levels throughout the night.
CPAP therapy is the term for the treatment approach itself. To get the best results, people diagnosed with sleep apnea are expected to use their CPAP machines consistently, all night, every night.
How Does CPAP Therapy Treat Sleep Apnea
What exactly is snoring, and how is it related to sleep apnea? If you snore or if you’ve been told you make gasping or choking sounds in your sleep, it’s likely you have OSA. Snoring is a sound caused by vibrations in your throat during breathing in sleep. These vibrations can be caused by a variety of reasons, ranging from alcohol consumption to colds and allergies, which impedes with your airway’s ability to take in air while you sleep. These temporary blockages or obstructions are events called apneas. However, one thing worth clarifying here is that while snoring and sleep apnea are often used synonymously they are not the same thing. Snoring is a symptom of OSA, but someone who snores does not necessarily sleep apnea.
If you’ve already tried the most common forms of snoring reduction and are ready for a sleep study to confirm whether or not you need sleep apnea treatment, let’s understand how CPAP therapy treats sleep apnea. Since you now know that snoring is a symptom of sleep apnea and that it’s an air blockage during sleep, you can guess that your CPAP machine is designed to provide your airways the air it needs during sleep. But, how does it do that?
A CPAP machine takes room air and passes it through an air filter that’s pressurized by your CPAP machine’s motor. The amount of pressurization required will be adjusted by your sleep specialist based on the results of your sleep study and can be adjusted over time. This measurement is basically how much pressure the motor of your CPAP must make to continuously push that air through the hose and to your airways and will be contingent on the severity of your sleep apnea. If your sleep apnea case is severe, you’ll need more pressure and vice-versa.
Another key function of a CPAP machine that helps to treat your sleep apnea is a CPAP humidifier. Most CPAP machines also have a humidifier built-in that gently moisturizes the filtered air to prevent you from having a dry throat or airway when you wake up. As you read on, you’ll also learn about a third key component of your CPAP therapy—your mask.
Reasons for Using a CPAP Machine
In addition to treating OSA and snoring, CPAP therapy helps treat several other conditions and issues. Some sleep-related and some not. Let’s dive in.
- Blood Pressure. Studies show that patients with hypertension experience a decrease in blood pressure while using a CPAP machine.
- Heart Disease. A study found that cardiovascular events decreased on those with coronary artery disease (CAD) as a result of CPAP therapy.
- Depression. CPAP wearers who use their machine nightly for at least seven hours reported feeling less depressed and more alert during the day.
- Reducing Stroke Risk: Strokes are also associated with sleep apnea. Meta-analyses reported that more than 50% of those who have had a stroke suffer from moderate to severe sleep apnea.
- Upper Airway Resistance Syndrome (UARS). A form of sleep-disordered breathing, UARS is the stage between mild snoring and full sleep apnea. When your airway reduces in diameter due to loose tissue, this constriction creates resistance. Air still moves into your lungs but not as easily. You may not experience apnea events where you stop breathing, but your sleep breathing will be heavy and labored. As you work harder to breathe, your brain may compensate by waking you up. Left untreated, UARS almost always develops into OSA. CPAP therapy is not necessarily the first line of treatment for UARS, but as the condition progresses, it’s often recommended to help keep the airway open.
Getting Started With CPAP
How do you get started with CPAP therapy? The first step is getting a diagnosis. To confirm you have sleep apnea, you’ll need to visit your primary care physician (PCP) to receive a referral to a sleep specialist. Your sleep specialist will advise you to complete a sleep study (polysomnogram) conducted at a sleep clinic or an at-home sleep study.
The polysomnogram is an overnight test that allows sleep technologists to collect comprehensive data about your sleep, such as your brain activity, blood oxygen levels, heart rate, and respiration. If you do have sleep apnea, sleep lab technologists will be able to track how often you stop breathing per each hour of sleep. In a home sleep study, a sleep lab will send you easy-to-use equipment that you can attach to yourself before sleeping at night; it records your pulse and breathing rates. You simply detach it from yourself in the morning and send the gear back to the lab for analysis. The results of either test are sent to your sleep specialist who will meet with you to determine a course of treatment.
If the sleep specialist prescribes you a CPAP machine, you may need a follow-up sleep titration study. This is a second overnight visit to the sleep center to determine which CPAP machine and mask are right for you as well as the correct pressure settings. During this visit, you will sleep while trying a few different CPAP masks and machines to determine the one that is most comfortable for you. The technologist will test different air pressure calibrations to determine a level that will clear your airway obstruction without disturbing your sleep.
Are CPAP Machines Hard to Use?
Simply put—no, CPAP machines are not difficult to use. They’re simple and effective devices with three main components:
- Machine. The CPAP machine is what sits on your bedside table. It’s a small, quiet compressor that takes in room temperature air and pressurizes it. The machine delivers pressurized and filtered air to your airway via a hose and mask. Some people opt to use the humidifier that comes with the machine to keep their nose, mouth, and throat from getting dry.
- Hose. The CPAP hose connects the machine to the mask. Hoses are specially created to flow air. They are typically six feet long and designed to successfully deliver your CPAP therapy.
- Mask. Depending on your particular breathing issues and fit requirements, your CPAP mask may go over your nose or over your nose and mouth together. Another style is the nasal pillow CPAP mask, which inserts into the nostrils from below. Masks are easy to use, but comfort will vary depending on your preferred sleeping position, body type, and many other variables. Therefore, it’s best to try different types of CPAP masks until you find the one that’s most comfortable.
CPAP machines and their components do need to be tested, serviced, and replaced periodically. This maintenance and upkeep is part of your prescription.
As you browse machines on your own online, you’ll likely come across three different types of machines, so it’s important to briefly mention them here for you to understand the different types. Ultimately, your sleep specialist will work with you to decide what machine you need.
A CPAP machine will normally be the first machine you’ll try, but contingent on the type of treatment you need, you may require an automatic positive airway pressure (APAP) machine or a variable positive airway pressure (VPAP) machine instead. An APAP machine automatically adjusts the pressure flow based on your breathing rates. A VPAP machine, also known as BiPAP, has two pressure rates: one for inhaling and one for exhaling.
Don’t forget that none of these three are the best—the best one is the one that is the most effective for treating your sleep apnea.
CPAP Therapy Is a Treatment, Not a Cure
CPAP is a marathon and not a sprint. You need to use your CPAP machine nightly for it to have any effect. Those who use it also report improvements in their daily life beyond a good night’s sleep. However, there’s still a variety of reasons why people fail to consistently use their CPAP machine:
- A poorly fitting CPAP mask
- A problem with tolerating the air pressure
- Aerophagia—swallowing air, which can lead to gas, flatulence, bloating, burping, or discomfort
- Humidification issues (or lack thereof), which lead to irritations of your throat and mouth
- Preconceived notions about CPAP therapy
Fortunately, most of these issues can be addressed by having the right equipment and right settings. If you have any stigmas about CPAP therapy, discuss them with your specialist and develop a plan on how to overcome them. Don’t forget that with CPAP therapy, you are making an investment in improving your health, so the best thing to do is educate yourself and learn how much better you may feel by consistently using your CPAP.
Contact your sleep physician if you do not feel like your sleep apnea symptoms are being treated properly, so they can re-evaluate your equipment and settings. Just like with anything else requiring long-term treatment, treating your sleep apnea is a long-term commitment—you may need to make occasional adjustments and modifications to keep your treatment working for you. The long-term benefits of sleep apnea treatment are worth the effort.
David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.