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Continuous Positive Airway Pressure

(CPAP)

Overview

 

People who are diagnosed with a sleep-related breathing disorder are often prescribed a treatment called positive airway pressure (PAP) therapy Although there are multiple ways of delivering PAP therapy, continuous positive airway pressure (CPAP) is a common sleep apnea treatment.

Consistent use of a CPAP machine provides both short- and long-term benefits to people diagnosed with sleep apnea. Learn about using a CPAP machine, choosing the right machine for you, and tips to help you get the most out of CPAP therapy.

 

What is a CPAP machine?

 

A CPAP machine is a bedside device that delivers positive airway pressure and is used to treat obstructive sleep apnea (OSA) and other breathing problems. People with OSA experience an abnormal number of shallow breaths or complete lapses in breathing while asleep. Abnormal nighttime breathing can result in snoring, daytime tiredness, nighttime awakenings, and a variety of other health complications.

CPAP therapy may also be prescribed to treat central sleep apnea (CSA), another sleep-related breathing disorder. In people with CSA, breathing slows or stops due to a lapse in the signals from the brain that regulate breathing.

To help reduce periods of abnormal breathing in people with sleep apnea, a CPAP machine pushes air into a person’s airway, keeping it open as they sleep. As a result, sleepers treated with CPAP should experience fewer obstructive apneas and central apneas during sleep.

A CPAP machine includes:

  • Mask: A mask sits over the sleeper’s nose or both their nose and mouth, creating a seal so air can be pushed into the airway without escaping.
  • Mask straps: Straps help keep the mask in position, so it remains on a person’s face as they sleep.
  • Tubing: A plastic tube or hose connects the mask to the CPAP machine’s motor that pushes out air. Air moves from the machine, through the tube, and into the mask and the airway.
  • Motor: The CPAP machine motor blows air into the connected tube. Most machines must be plugged into an electrical outlet to power the motor, but some battery-operated CPAP machines are available. The motor component of the machine also often contains an air filter and, in some cases, a heated humidifier.
  • Air Filter: An air filter that purifies the air entering your nose or mouth.

Some CPAP machines have other features as well, like heated humidifiers and adjustable pressure settings.

1. CPAP Machines

Continuous positive airway pressure is the most common type of PAP therapy. CPAP machines provide constant pressure to keep your upper airway open as you sleep. Some CPAP machines include a pressure relief setting to slightly lower the amount of pressure during exhalation.

2. APAP Machines

Auto-adjusting positive airway pressure (APAP) machines, also referred to as auto-CPAP, can raise or lower the pressure based on your breathing patterns. This is often more comfortable for sleepers whose pressure needs change between sleep positions, or those who have trouble tolerating CPAP therapy.

3. BiPAP Machines

Bilevel positive airway pressure (BiPAP or BPAP) machines have two pressure settings, switching between a higher pressure as you inhale and a lower pressure as you exhale. BiPAP machines often have a wider pressure range, reaching up to 30 cm H2O.

4. Travel CPAP Machines

Travel CPAP machines work like traditional CPAP machines but have a more portable design. These devices are usually small and lightweight. Some models are also FAA-approved and can be used in flight, though specific policies may vary by airline.

 

Breakdown of PAP Machine Types

Type Design
Features		 Benefits Cost
CPAP CPAP machines are designed to deliver a constant level of pressure to the airways while you sleep. CPAP can be an effective treatment for people experiencing OSA. With a simple design, CPAP machines are also the most affordable type of PAP machine. CPAP machines generally cost between $500 and $1,000. Traditional CPAP machines are usually the least expensive type of PAP device. However, models with more features tend to be more expensive.
APAP APAP machines are more advanced than traditional CPAP devices. As you sleep, the machine can increase pressure when it senses a respiratory event. APAP machines adjust the pressure based on your breathing patterns, which may be more comfortable for sleepers whose needs change throughout the night. APAP machines typically range from $600 to $1,600. They are usually more expensive than traditional CPAP machines because they must detect and change pressure in response to the sleeper’s breathing.
BiPAP A BiPAP machine can sense when you inhale and exhale to administer higher-pressure air as you breathe in. BiPAP machines may be more comfortable at higher pressures than CPAP machines. BiPAP therapy is also used for people with more complex or severe breathing issues. Because this is a more advanced type of PAP machine, it is also more expensive. BiPAP devices usually cost $1,700 to $3,000.
Travel CPAP Travel CPAP machines have the same therapeutic benefits as regular CPAP devices. However, they are designed to be portable for easy travel use. This style of CPAP device allows travelers to keep up with their PAP therapy while on the road. Travel CPAP devices typically cost $450 to $1,200.

What is a CPAP machine used for?

CPAP machines treat obstructive sleep apnea (OSA). In OSA, you briefly stop breathing while you sleep when your airways relax so much that they narrow down or completely close. This can happen hundreds of times in a single night, leading to a lack of oxygen. Untreated sleep apnea increases your risk for conditions like:

Untreated OSA can also increase your risk of being in a vehicle accident while driving.

Using a CPAP machine when you sleep keeps your airways open, so you don’t stop breathing.

Healthcare providers use CPAP machines for other types of breathing problems. For example, they use it for preterm infants in the neonatal intensive care unit (NICU) whose lungs haven’t yet fully developed.

What does a CPAP machine do?

A CPAP machine operates by pushing air through a tube into a sleeper’s nose, mouth, or both as they sleep. This air applies pressure to the airway, reducing the likelihood the airway will collapse and obstruct breathing. With a traditional CPAP machine, air is pushed out continuously at one fixed rate of pressure.

CPAP machines are not the only machines that can provide positive airway pressure. Understanding the differences among the various machines that deliver PAP therapy may help shed light on why a certain type of machine is recommended by a doctor or sleep specialist.

For the sleep apnea treatment to work, you must use your CPAP machine every time you sleep. This includes at home, while traveling and during naps.

You must also clean your mask and tube every day and refill your medical device prescription when necessary to replace the mask and tube.

Types of CPAP masks

CPAP machines mainly vary in the type of mask you can use with it. The kind that’s best for you depends on your comfort level, breathing habits and the type of sleep apnea you have. CPAP mask types include:

  • Nasal mask: This option covers your nose. Healthcare providers often recommend a nasal mask if you move around a lot when you sleep.
  • Nasal pillow mask: Rather than covering your entire nose, a nasal pillow mask only covers your nostril area. Some options also have prongs that fit into your nostrils. People who wear nasal pillow masks can wear their glasses comfortably.
  • Full mask: This triangular mask fits over your nose and mouth. A full mask is best if you breathe through your mouth during sleep. Your provider may also recommend this type of mask if you have a nasal blockage.
  • Hybrid mask: This is a type of full face mask that fits over your mouth and has prongs or cushions that seal your nostrils without covering the bridge of your nose.
  • Oral mask: An oral mask is an uncommon style that covers just the mouth.

Your provider will go over your options with you. They’ll also work with you to find the best type and fit of mask. Don’t hesitate to ask questions or voice your concerns. Some people end up trying a few different masks before they find the one that they like best.

 

Pros & Cons

 

What are the benefits of a CPAP machine?

Consistently using a CPAP machine to treat sleep apnea has both short- and long-term benefits.

The main benefit of using a CPAP machine is that it reduces breathing interruptions when you sleep. Because of this, short-term benefits include:

  • Improved sleep quality, which may make you feel better rested.
  • Reduced snoring.
  • Less daytime sleepiness (hypersomnia).
  • Increased work productivity
  • Improved mood.

Long-term benefits of consistent CPAP machine use may include:

What are the downsides of a CPAP machine?

The first few times you use a CPAP machine may be difficult. Many people at first find the mask uncomfortable, claustrophobic and/or embarrassing. It may be difficult to fall asleep at first. It can also be cumbersome to travel with a CPAP machine.

Know that there are strategies for overcoming these obstacles. CPAP machines are effective, and it’s important to stick with this treatment. It may be helpful to talk to others who use CPAP machines to learn tips and tricks.

What are the side effects of using a CPAP machine?

Side effects of CPAP treatment may include:

  • Congestion.
  • Runny nose.
  • Irritated eyes
  • Dry mouth.
  • Sore throat
  • Nosebleeds.
  • Redness or irritation on top of the nose
  • Bloating or nausea
  • Respiratory infection

When a person first begins using a CPAP machine, they might find the mask uncomfortable. They may also feel embarrassed or claustrophobic while wearing it. A person’s doctor or sleep specialist can help to minimize side effects by making adjustments or trying another mask type, or by offering suggestions to make using a CPAP machine more comfortable.

These side effects typically happen due to cold, dry air. Using a heated humidifier can often help.

CPAP masks may cause skin irritation or redness. But using the right size mask and padding can minimize these issues. Talk to your healthcare provider if you’re having bothersome side effects.

 

Tips for Comfortably Using a CPAP Machine

 

Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. A CPAP machine uses a hose connected to a mask or nosepiece to deliver constant and steady air pressure to help you breathe while you sleep.

Common problems with CPAP include a leaky mask, trouble falling asleep, a stuffy nose and a dry mouth.

But if a CPAP mask or machine doesn’t work for you, you have other options. And most CPAP masks can be adjusted to help make them more comfortable.

Here are 10 common CPAP problems and what you can do about them:

1. The wrong size or style CPAP mask

Work closely with your healthcare professional and the CPAP supplier to make sure you have a CPAP mask that fits properly. People have different face shapes, so the right mask style and size for someone else may not work for you.

  • Try a different mask. A range of CPAP masks is available. For example, a full face mask covers the mouth and nose, with straps that stretch across the forehead and cheeks. These may make some people feel claustrophobic, but they work well for those who prefer to breathe through their mouths during sleep. They also provide a stable fit for people who move around a lot during sleep. Other masks feature nasal pillows that fit under your nose and straps that cover less of your face. These can feel less cumbersome. Nasal pillows may work well if you wear glasses or read with the mask on because some don't block the eyes as much as full face masks do. However, this mask style may not be an option if you move around a lot during sleep or have difficulty breathing through your nose, such as due to congestion.
  • Pay attention to size. Most masks come in different sizes. Just because you're a certain size in one mask doesn't mean you'll be the same size in another. CPAP masks are usually adjustable. Ask your healthcare professional or CPAP supplier to show you how to adjust your mask to get the best fit. Manufacturer product instructions also can help show you how to do this. A properly fitting mask shouldn't be uncomfortable or cause pain.

2. Trouble getting used to wearing the CPAP mask

First, try wearing just the CPAP mask for short periods of time while you're awake — for example, while watching TV. Then try wearing the mask and hose with the machine turned on during the day while you're awake.

Once you get used to how that feels, start using the CPAP machine every time you sleep — including during naps. Only using the CPAP machine every now and then may delay getting used to it. Stick with it for several weeks or more to see if your mask and pressure are right for you.

3. Difficulty tolerating forced air

You may be able to overcome this by using a machine with a "ramp" feature. This setting allows you to start with low air pressure. The machine then automatically and slowly increases the air pressure to your prescribed setting as you fall asleep. Your healthcare professional can adjust its rate.

If this feature doesn't help, talk with your healthcare team about changing to a machine that automatically and constantly adjusts the pressure while you're sleeping. An example is a bi-level positive airway pressure (BPAP) machine that delivers more pressure when you breathe in, called inhale, and less when you breathe out, called exhale.

4. Dry, stuffy nose

Check to make sure your mask fits well. A leaky mask can dry out your nose. If you have to tighten the straps often to prevent air leakage, the mask does not fit properly.

A CPAP machine that features a heated humidifier, which attaches to the air pressure machine, can help. You can adjust the level of humidification. Using a nasal saline spray at bedtime also can help ease a dry, stuffy nose.

5. Feeling claustrophobic

Practice using your mask while you're awake. First, just hold it up to your face without any of the other parts. Once you're comfortable with that, try wearing the mask with the straps.

Next, try holding the mask with the attached hose on your face, without using the straps. Turn on the CPAP machine, perhaps with the ramp feature turned on. Next, do this using the straps too. Finally, try sleeping with the mask and machine on.

Relaxation exercises, such as progressive muscle relaxation, may help reduce anxiety related to CPAP use.

If you're still feeling claustrophobic, talk with your healthcare professional or CPAP supplier. It may help to get a different size mask or try a different style, such as one that uses nasal pillows.

6. Leaky mask, skin irritation or pressure sores

A leaky or an ill-fitting mask means you're not getting the full air pressure you need, and it may be irritating your skin. The mask also can direct air into your eyes, causing them to become dry or teary.

Try adjusting pads and straps to get a better fit. If the mask fits over your nose, make sure it doesn't sit too high on the bridge of your nose, which can direct air into your eyes.

You may need to ask your CPAP supplier to help you find a different size mask, particularly if your weight has changed a lot. Or try a different style mask such as one that uses nasal pillows. If you develop skin deterioration or sores, such as on your nose, tell your care team promptly.

7. Difficulty falling asleep

Wearing the mask alone for some time during the day may help you get used to how it feels and make it easier to fall asleep at night.

Machines with the ramp feature that slowly and gradually increase the air pressure to your prescribed pressure setting as you fall asleep may make you more comfortable at bedtime.

Following good general sleep habits also is helpful. Exercise regularly and avoid caffeine and alcohol before bedtime. Try to relax. For example, take a warm bath before you go to bed. A white noise machine may help.

8. Dry mouth

If you breathe through your mouth at night or sleep with your mouth open, some CPAP machines may worsen dry mouth. A chin strap may help keep your mouth closed and reduce the air leak if you wear a nasal mask.

A machine with a full face mask that covers your mouth and nose also may work well for you. A CPAP-heated humidifier that attaches to the air pressure machine also may help.

9. Accidentally removing the CPAP mask during the night

It's not unusual to sometimes wake up to find that you've removed the mask in your sleep. If you move a lot in your sleep, you may find that a full face mask will stay on your face better. You may have removed your mask while sleeping because you were uncomfortable. Consider trying a different type of mask that may fit you better.

You may be pulling off the mask because your nose is congested. If so, ensuring a good mask fit and adding a CPAP-heated humidifier may help. A chin strap may help keep the mask on your face.

If removing the mask is a consistent problem, consider setting an alarm for a time during the night so you can check whether the mask is still on. You could progressively set the alarm for later in the night if you find that you're keeping the mask on longer.

10. Bothersome noise

Most new models of CPAP machines are almost silent. But if you find that your machine's noise is bothersome, first check to make sure the machine's air filter is clean and unblocked. Something in its way may worsen noise. Ask your healthcare provider or CPAP supplier how to properly clean your mask and hose.

If cleaning doesn't help, have your care team or CPAP supplier check the machine to ensure it's working properly. If the machine is working correctly and the noise still bothers you, try wearing earplugs or using a white noise machine to mask the noise. Placing the CPAP machine as far away from the bed as possible also may help make any machine noise less noticeable. Ask your healthcare professional or CPAP supplier if extra tubing is available and right for your machine.

Time and patience are key to success

Using a CPAP machine can be frustrating as you try to get used to it, but it's important that you stick with it. The treatment is essential to avoiding complications of obstructive sleep apnea, such as heart problems and excessive daytime sleepiness.

Work with your care team and CPAP supplier to ensure the best mask fit and device for you. Regular visits to your healthcare professional are important and can help troubleshoot any problems and adjust settings, if needed. It can take a while to find the correct settings and get used to the mask.

With time and patience, CPAP can positively affect your quality of life and health.

 

How to Select the Right CPAP Machine for You

 

A physician can help determine whether PAP therapy is right for you and decide which type of machine best suits your needs and condition. While CPAP therapy is often the first-line treatment for obstructive sleep apnea, APAP and BiPAP can be useful for those who have problems with traditional CPAP machines.

CPAP Machines

CPAP machines are the simplest, most affordable, and most widely available option for sleepers experiencing OSA symptoms. If you are on a budget or looking for the biggest selection of models and features, a traditional CPAP machine may be the best choice. Additionally, CPAP therapy is typically the first line of treatment for OSA. If you are newly diagnosed, your doctor will likely start you off with a CPAP machine and see how you respond.

APAP Machines

APAP machines are useful for those who have trouble sleeping with the constant pressure of a CPAP machine. They can also be effective for sleepers who experience regular changes in their breathing patterns, like allergy sufferers or those who change sleep positions frequently.

BiPAP Machines

BiPAP machines provide a more specialized form of PAP therapy. A doctor usually only prescribes BiPAP treatment for people with OSA if they do not respond to traditional CPAP therapy. BiPAP can also be effective for sleepers with other breathing-related conditions, such as central sleep apnea

Travel CPAP Machines

A travel CPAP machine is a convenient solution for people with OSA who occasionally sleep away from home. Travel CPAP devices are small, lightweight, and easy to pack. While you may be able to take a traditional CPAP machine on your travels, their bulkier designs can be cumbersome.

 

TOP CPAP/APAP/BiPAP Machines Comparison

Product
 Name		 Type Humidification Screen
 Type		 Auto
Adjusting		 Ramp
Function		 Portable Wireless
Connectivity		 Ideal
For
ResMed AirSense™ 11 AutoSet™ Auto CPAP HumidAir™ LED Touchscreen Yes Yes No Bluetooth Individuals with sleep apnea seeking comfort and easy-to-use settings
Philips DreamStation 2 Auto CPAP Auto CPAP Heated Humidifier Color LCD Screen Yes Yes Yes Bluetooth People needing a compact, high-performance machine with reliable therapy
ResMed AirCurve™ 10 S BiPAP BiPAP HumidAir™ Color LCD Screen Yes Yes NO Wireless Individuals requiring bilevel therapy for complex sleep apnea
Philips Respironics DreamStation Go Auto CPAP Precision Humidity Touchscreen Yes Yes Yes Wi-Fi Travelers who need a compact, high-quality CPAP for portability
VentMed ZenSleep Auto CPAP Auto CPAP Heated hose & humidifier Split LCD Display Yes Yes Yes Bluetooth Individuals preferring customizable settings and remote monitoring
ResMed AirMini™ Auto CPAP HumidX™ LED Display Yes Yes Yes Bluetooth Frequent travelers needing the smallest and most portable CPAP device
ResMed AirCurve™ 10 VAuto BiPAP HumidAir™ LCD Color Screen Yes Yes NO Wireless Users needing advanced bilevel therapy with automatic pressure adjustments
VentMed DreamSleep™ DS6 Auto CPAP Heated humidifier LCD Display Yes Yes Yes NO Users seeking a reliable, easy-to-use CPAP with auto-adjusting settings

 

Do You Need a Prescription for a CPAP Machine?

 

All PAP machines require a prescription from a physician. The Food and Drug Administration regulates them as Class II medical devices. Consulting with a licensed medical professional is essential to ensuring that the therapy is safe and effective. Your doctor may also order an overnight titration study to determine the best pressure setting for you.

Will Medicare or Health Insurance Pay for a CPAP Machine?

Medicare and health insurance plans usually cover part of the cost of a CPAP machine. How much your plan covers may depend on the severity of your symptoms.

Medicare may cover a three-month trial period of CPAP therapy for people diagnosed with obstructive sleep apnea. After the trial, Medicare may continue coverage if you meet certain requirements and your doctor determines that CPAP treatment improves your symptoms. In addition to contributing to the cost of machine rental after you meet your Plan B deductible, Medicare also covers part of the cost for other CPAP supplies, like masks and tubing.

Other health insurance plans vary in their coverage and authorization requirements. Many cover a portion of the cost of a CPAP machine. Some providers consider your apnea-hypopnea index (AHI), a measure of OSA severity, when deciding the amount of coverage.

If you pay out of pocket for your CPAP equipment, you will need to submit a claim for reimbursement. Verify that your insurance covers out-of-pocket expenses before making a purchase. After your purchase, keep your receipt, complete the appropriate claims form, and submit the required documentation to your insurance company.

 

Additional Common Questions

 

Are there alternatives to CPAP machines?

Yes. CPAP machines are the most common sleep apnea treatment. But there are alternatives, including:

  • Oral appliance therapy: A dentist who specializes in oral appliance therapy can make a custom device that fits over your teeth. This device opens your airway by placing your jaw in a more favorable position. Oral appliances work best for mild or moderate cases of obstructive sleep apnea.
  • Positional therapy: People who sleep on their backs are more prone to apnea episodes. Certain devices encourage you to sleep on your side or stomach to reduce your risk for sleep apnea.
  • Weight management: Obesity is one of the leading causes of obstructive sleep apnea. You may be able to reduce your risk for the condition by losing weight.
  • Surgery: You may need surgery for certain causes of sleep apnea. Common options include soft tissue removal, jaw repositioning or an implantable nerve stimulator for hypoglossal nerve stimulation.

Depending on your situation, your healthcare provider may recommend more than one therapy or strategy to address sleep apnea.

Do CPAP machines really help?

Research shows that CPAP machines are incredibly effective in treating sleep apnea when you use them consistently. CPAP is often the first line of defense against the condition.

How Much Do CPAP Machines Cost?

CPAP machines range from about $500 to $1,000 or more. Optional features like a heated humidifier can add to the cost of a CPAP machine.

Health insurance may cover some or all of the cost of a CPAP machine. Check with your insurance provider or doctor to learn how much you would have to pay out-of-pocket for a CPAP machine. Follow-up visits with a doctor or sleep-specialist may be required for continued coverage of your CPAP machine.

Does Medicare Cover CPAP Machines?

If you are diagnosed with obstructive sleep apnea and both your doctor and CPAP supplier are enrolled in Medicare, then Medicare will cover some of the cost of your CPAP machine. Initially, they may only cover a three-month trial, then require additional doctor’s visits before continuing coverage. You may still have to pay out-of-pocket for 20% of the cost of a CPAP machine and accessory supplies, like the mask and tube.

How Can I Get a CPAP Machine?

The first step in getting a CPAP machine is to see a doctor to learn if CPAP therapy is right for you. After an initial evaluation, a doctor may refer you to a sleep specialist, who can order a sleep study if they suspect you have a form of sleep-disordered breathing. If the sleep study confirms that you could benefit from CPAP therapy, your sleep specialist or doctor will instruct you on how to select and purchase a CPAP machine.

How Do CPAP Machines Know When You Stop Breathing?

A fixed-air CPAP releases air at a constant rate of pressure, regardless of whether or not you are breathing normally or experiencing a lapse in breathing. An APAP machine uses sensors and technology to determine when a person has slowed or stopped breathing. Then, the APAP adjusts its airflow accordingly.

Since an APAP machine can detect when a person has stopped or slowed their breathing, it can also provide an estimate of how many abnormal breathing events a person experiences per night and per hour. The machine can also detect when the mask is leaking air.

 

One Final Note..

 

If you have sleep apnea, a CPAP (continuous positive airway pressure) machine may be your healthcare provider’s first recommendation for treating it. Needing a to use machine to sleep may feel embarrassing or annoying. But quality sleep is vitally important to your overall health. And a CPAP machine can offer it. If you’re not comfortable with your CPAP machine, talk to your provider. There are several types of masks and machines you can try. With a little trial and error, you’ll be able to get restful shuteye.

 

 

 

 

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Copyright © 2000 - 2025    K. Kerr

Most recent revision June 30, 2025 08:08:43 PM

 

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